Correlation of intraabdominal fat accumulation and left ventricular performance in obesity

The correlation of intraabdominal visceral fat accumulation and left ventricular performance was investigated in 37 obese patients who had 154 +/- 23% of ideal body weight. The left ventricle was studied noninvasively by means of echocardiography, whereas the distribution of body fat was determined by computed tomography. The end-diastolic left ventricular dimension and stroke volume were greater in obese patients than in non-obese control subjects. Not only the absolute values of these parameters, but also the diastolic left ventricular dimension index (calculated as end-diastolic dimension/cube root of body surface area) and stroke index were greater in obese patients. When the obese patients were divided into 2 groups according to the intraabdominal visceral fat area to subcutaneous fat area ratio (V/S) determined by computed tomography, the diastolic dimension index and the stroke index were significantly greater in visceral-type obesity (V/S greater than or equal to 0.4) than in subcutaneous-type obesity (V/S less than 0.4) (43.2 +/- 2.9 vs 40.3 +/- 3.1 mm/m2/3, p less than 0.01 and 49.3 +/- 6.1 vs 40.3 +/- 5.6 ml/m2, respectively). Multiple regression analysis with independent variables of age, body weight, duration of obesity and V/S ratio showed that diastolic dimension index and stroke index significantly correlated with the V/S ratio. Thus, the alteration of cardiac function in obese patients is attributable not only to excess body weight and duration of obesity but also to intraabdominal fat accumulation.