Successful weight reduction improves left ventricular diastolic function and physical performance in severe obesity

Area of Science:

• Cardiology
• Metabolic Health
• Obesity Research

Background:

• Obesity and metabolic syndrome (MetS) are established risk factors for left ventricular diastolic dysfunction (LVDD).
• The impact of successful weight reduction (WR) on diastolic function and physical performance in obese individuals remains less understood.

Purpose of the Study:

• To investigate the effects of a 1-year weight reduction program on diastolic function and exercise capacity in severely obese subjects.
• To identify predictors of improvement in diastolic function following weight loss.

Main Methods:

• 188 obese subjects (BMI 40.2 ± 8.6 kg/m²) participated in a 1-year diet and lifestyle intervention program.
• Echocardiography and 6-minute walk tests were conducted at baseline and after 1 year.
• Subjects were dichotomized into "successful WR" (≥ median weight loss of 8%) and "failed-WR" (< median weight loss) groups.

Main Results:

• Successful WR significantly improved MetS alterations, including glucose, insulin, lipids, adipokines, blood pressure, and epicardial fat thickness.
• Subjects with successful WR showed significant improvements in LVDD echocardiographic parameters (e.g., e', e'/a', E/e', E/A) and 6-minute walk distance.
• Reduction in epicardial fat thickness was a key predictor for improved diastolic function.

Conclusions:

• Successful long-term weight reduction in severe obesity is associated with marked improvements in left ventricular diastolic function.
• Weight reduction also enhances exercise capacity and metabolic health in obese individuals.
• Targeting epicardial fat may be crucial for improving diastolic function in obese patients.