Early LV remodelling patterns in overweight and obesity: Feasibility of cardiac CT to detect early geometric left...

Obesity is an in independent risk factor for cardiovascular disease.

To describe the early LV remodelling pattern in patients with overweight and obesity and structurally normal hearts.

Consecutive patients (n = 2374), with structurally normal hearts and BMI ≥ 18.5 kg/m², undergoing prospective mid-diastolic ECG gated CTCA were selected. Left ventricular mass (LVM) and Left ventricular mid-diastolic volume (LVMDV) were measured. The concentricity index (LVM/LVMDV) were calculated. According to the definitions of the World Health Organization (WHO), the patients were divided into weight categories.

The mean LVM ± Std. deviation in the subgroups according to WHO classification was 101.68 ± 28.99 g (normal weight), 115.79 ± 29.14 g (overweight), 123.8 ± 33.44 g (class I obesity), 125.85 ± 32.89 g (class II obesity) and 132.45 ± 37.85 g (class III obesity). (p < 0.001) The mean LVMDV progressed with increasing WHO weight category from 112.37 ± 36.46 in patients with normal BMI to 140.26 ± 43.78 in patients with class III obesity. (p < 0.001) The concentricity index was 0.935 ± 0.216 g/ml in patients with normal BMI, 0.979 ± 0.253 g/ml, 1.058 ± 0.635 g/ml, 0.996 ± 0.284 g/ml and 0.9768 ± 0.244 g/ml in patients with BMI categories 25-29.99, 30-34.99, 35-39.99 and ≥40 kg/m², respectively.

Our study demonstrates a non-linear (inverse U-shape) relationship between increasing BMI class and concentricity index, reaching its maximum at a BMI of 30-34.99 kg/m². Further increase in BMI results in LV dilation.