Impact of different grades of body mass index on left ventricular structure and function

Overweight and obesity influences left ventricular structure and function. WHO Western Pacific Region in 2000 recommended lower cutoff for overweight (Body Mass Index-BMI > or = 23.0) and obesity (Body Mass Index-BMI > or = 25.0) in Asians. However, studies considering the new recommendations of body mass index (BMI) are lacking. The present study investigated the impact of different grades of BMI on left ventricular structure and systolic and diastolic function in middle aged Indian men. The study involved 74 men aged 31 to 60 (mean age 45.24 +/- 10.9) years who were grouped according to BMI as normal weight (18.5-22.9 kg/m2, n=19), overweight (23-24.9 kg/m2, n=17) and obese (> or =25 kg/m2, n=38). Left ventricular structure and function were evaluated by 2-D doppler echocardiography. Compared to normal and overweight, obese had significantly higher left ventricular mass (P < 0.05) and left atrial diameter (P < 0.01). Left ventricular diastolic function (atrial filling velocity-A) showed a significant decline in obese and even in overweight compared to normal (P < 0.05). Left ventricular systolic function showed no significant changes with increase in BMI. Left ventricular diastolic function decreases in all grades of BMI more than 23 kg/m2, whereas structural changes are present only in obese (BMI > or =25 kg/m2). Hence the revised BMI cut-off for Asians as recommended by WHO need to be considered for assessing cardiovascular risk and mortality among Indian men and more stringent control of body weight especially abdominal obesity is justified in the maintenance of cardiovascular health and functional capacity.