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Updated: Jul 15, 2026
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A Rat Model of Pressure Overload Induced Moderate Remodeling and Systolic Dysfunction as Opposed to Overt Systolic Heart Failure
Published on: April 30, 2020
Cardiac Remodeling and Dysfunction Associated in Populations With Obesity: An Analysis of Cardiac Structure and
Shaun Khanna1,2, Dylan Wilson3, Gurkeerat Mann3
1The George Institute for Global Health, UNSW Sydney, Kensington, NSW, Australia.
Summary
Obesity causes distinct heart changes, including more epicardial fat and impaired systolic function, even with normal ejection fraction. These early, potentially reversible changes contribute to increased cardiovascular risk.
Area of Science:
- Cardiology
- Obesity Medicine
- Medical Imaging
Background:
- Obesity is linked to cardiovascular disease, but its effects on subclinical cardiac remodeling are not fully understood.
- Cardiac magnetic resonance (CMR) is a key tool for assessing myocardial structure, function, and adiposity.
- This study aimed to define the cardiac phenotype associated with obesity using CMR.
Purpose of the Study:
- To systematically review and meta-analyze studies using CMR to characterize cardiac remodeling in adults with obesity.
- To identify specific CMR-derived parameters altered in individuals with obesity compared to controls.
- To understand the relationship between obesity and subclinical cardiac dysfunction.
Main Methods:
- A systematic literature search was conducted across major databases (PubMed, MEDLINE, EMBASE, etc.) from 2000-2025.
- Studies comparing CMR parameters in adults with obesity (WHO criteria) versus non-obese controls were included.
- Random-effects meta-analysis was used to pool standardized mean differences (SMDs); sensitivity analyses and meta-regression explored heterogeneity.
Main Results:
- Twenty studies including 1395 individuals with obesity and 1260 controls were analyzed.
- Obesity was associated with increased epicardial fat, higher left ventricular mass/end-diastolic volume ratio, and increased stroke volume.
- Global longitudinal strain (GLS) was impaired, indicating subclinical systolic dysfunction, despite preserved ejection fraction. Body mass index modified GLS, while age influenced left ventricular mass.
Conclusions:
- Obesity presents a distinct CMR phenotype: concentric ventricular remodeling, excess epicardial fat, hemodynamic adaptation, and early subclinical myocardial dysfunction.
- These cardiac adaptations, despite preserved ejection fraction, contribute to the elevated cardiovascular risk in obesity.
- The identified cardiac changes may be reversible, highlighting potential therapeutic targets.
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