Assessment of myocardial mechanics in overweight and obese Indian subjects

Obesity is associated with increased cardiovascular morbidity and mortality. A direct effect of isolated obesity on cardiac function is not well established. The study was designed to determine the direct effect of various grades of isolated obesity on Echocardiographic indices of systolic and diastolic left ventricular function. Forty five overweight & obese and 30 normal weight, serving personnel without any other pathological condition were studied. Group I (n = 23) consisted of subjects with normal weight and body mass index (BMI 18.5-22.9 kg/m2), Group II (n = 28) of overweight subjects (BMI 23-24.9 kg/m2) and Group III (n = 24) of obese subjects (BMI > or = 25 kg/m2). Echocardiographic indices of systolic and diastolic function were obtained and dysfunction was assumed when at least two values differed by > or = 2 SD from the normal weight group. Ejection fraction was increased (p = 0.001) in group II and III however fractional shortening was increased significantly in group III (< 0.001). Left ventricular dimensions (EDD & ESD) were increased (P < 0.001, 0.002) but relative wall thickness was unchanged in group II & III. Systolic dysfunction was not observed in any of the obese patients. The deceleration time was increased (P < 0.01) in overweight and obese subjects compared to normal group individuals. No difference was found between obesity subgroups. Subclinical diastolic dysfunction in the form of reduced E/A ratio and increased deceleration time was more prevalent among obese subjects. BMI correlated significantly with indices of left ventricular systolic and diastolic function. Subclinical left ventricular diastolic dysfunction was noted in all grades of obesity which correlates with BMI.