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Obesity related changes in cardiac structure and function: role of blood pressure and metabolic abnormalities

Tiziana Di Chiara1, Antonino Tuttolomondo1, Gaspare Parrinello1

  • 1Dipartimento PROMISE, University of Palermo, School of Medicine, Palermo, ltaly.

Acta Cardiologica
|April 25, 2019
PubMed

Insights

Obese individuals with left ventricular hypertrophy (LVH) exhibit distinct characteristics, including increased cardiometabolic risks and early systolic dysfunction. This suggests LVH may represent a unique obesity phenotype requiring targeted management.

Area of Science:

  • Cardiology
  • Obesity Medicine
  • Metabolic Syndrome

Background:

  • Obesity is linked to cardiac structural and functional changes due to hemodynamic and non-hemodynamic factors.
  • Left ventricular hypertrophy (LVH) is a known cardiac adaptation in obesity.
  • Understanding LVH's impact on systolic and diastolic function is crucial for managing cardiovascular risk in obese populations.

Purpose of the Study:

  • To evaluate the prevalence of left ventricular hypertrophy (LVH) in obese patients.
  • To assess the effects of LVH on left ventricular systolic and diastolic function in obese individuals.
  • To identify clinical and biochemical markers associated with LVH in obesity.

Main Methods:

  • Echocardiography and Doppler were used to measure left ventricular internal diameter (LVID), mass (LVM), mass index (LVMI), relative wall thickness (RWT), ejection fraction (LVEF), and diastolic parameters.
  • Pulsed-wave Doppler assessed isovolumic relaxation time and deceleration time of E velocity.
  • Radioimmunoassay measured total circulating adiponectin (ADPN) in 319 obese subjects with and without LVH.

Main Results:

  • Obese subjects with LVH showed significantly higher BMI, waist-hip ratio (WHR), blood pressure, LVID, LVM, LVMI, and prevalence of hypertension, diabetes, and metabolic syndrome compared to controls.
  • LVH subjects had lower adiponectin (ADPN) and LVEF, with no significant differences in diastolic parameters.
  • LVEF correlated positively with ADPN and negatively with age, BMI, WHR, mean blood pressure (MBP), metabolic syndrome (MetS), and LVMI; WHR, MBP, LVMI, and ADPN were independent predictors of LVEF.

Conclusions:

  • Obese individuals with LVH represent a distinct phenotype characterized by cardiac remodeling, cardiometabolic comorbidities, and central obesity.
  • This phenotype is associated with hypoadiponectinemia and early left ventricular systolic dysfunction.
  • Findings suggest LVH in obesity signifies an increased cardiovascular risk profile.

Keywords:
Obesityadiponectinhypertensionleft ventricular hypertrophywaist to hip ratio

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