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Contribution of obesity to left atrial and left ventricular dysfunction in asymptomatic patients with hypertension: A

Hirokazu Miyoshi1, Yoshifumi Oishi1, Yukio Mizuguchi1

  • 1Cardiovascular Section, Higashi Tokushima Medical Center, National Hospital Organization, Tokushima, Japan.

Journal of the American Society of Hypertension : JASH
|October 18, 2013
PubMed

Insights

Obesity accelerates heart dysfunction in hypertensive patients. Two-dimensional speckle-tracking echocardiography reveals impaired left atrial-left ventricular interaction, highlighting obesity

Area of Science:

  • Cardiology
  • Echocardiography
  • Cardiovascular Imaging

Background:

  • Hypertension and obesity are known contributors to heart failure with preserved ejection fraction.
  • Understanding the impact of obesity on left atrial-left ventricular (LA-LV) interaction in hypertensive patients is clinically significant.
  • Asymptomatic patients with hypertension and obesity require further investigation into cardiac function deterioration.

Purpose of the Study:

  • To clarify the mechanisms of LA-LV interaction deterioration in asymptomatic hypertensive patients with obesity.
  • To assess the influence of obesity on cardiac function in the presence of hypertension.
  • To evaluate the utility of two-dimensional speckle-tracking echocardiography (2DSTE) in detecting subclinical cardiac changes.

Main Methods:

  • 134 asymptomatic hypertensive patients were studied using conventional and 2DSTE.
  • Patients were categorized into non-obese (BMI <25 kg/m²) and obese (BMI ≥25 kg/m²) groups.
  • Analysis focused on parameters including end-diastolic LV diameter, E/e', peak systolic LV strain rates, and LA strain (S-LAs).

Main Results:

  • The obese group exhibited greater end-diastolic LV diameter, E/e', peak systolic LV circumferential strain rate, and E/e'/S-LAs.
  • Multivariate analysis identified Body Mass Index (BMI) as independently associated with end-diastolic LV diameter and peak systolic LV radial strain in all patients.
  • In obese patients, age, systolic blood pressure, relative LV wall thickness, s', peak systolic LV radial strain, and peak early diastolic LV longitudinal strain rate independently predicted E/e'/S-LAs; in non-obese patients, only s' was a predictor.

Conclusions:

  • Obesity accelerates impaired LA-LV interaction in hypertensive individuals.
  • 2DSTE provides valuable insights into the detrimental effects of cardiovascular risk factors on LA and LV function in asymptomatic patients.
  • Early detection of cardiac dysfunction using advanced echocardiographic techniques is crucial for managing hypertensive and obese populations.

Keywords:
2-D speckle-tracking echocardiographyLA-LV couplinghypertensionobesity

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