Even short-term obesity leads to subclinical dysfunction of both ventricles in young individuals

Obesity affects over 1.5 billion adults worldwide, necessitating early cardiovascular detection. We identified subclinical biventricular dysfunction in young overweight/obese individuals.

In this prospective study (2023-2024), 60 participants were enrolled: 30 overweight/obese individuals (BMI ≥ 25 kg/m²) and 30 age-sex-matched controls. Conventional echocardiography, tissue Doppler imaging, and 2D speckle tracking strain analysis were performed. Stepwise multiple linear regression identified independent predictors of RWT, LV GLS, e' medial, RV S' and RV_FWLS, entering BMI, age, sex, blood pressure, heart rate, SPAP (RV_FWLS) and metabolic variables (obese group). Variables required p < 0.10 in univariate analysis.

Obese individuals showed LV remodeling: greater posterior (9.1 ± 1.2 vs. 8.1 ± 1.2 mm, p < 0.01) and septal wall thickness (10.1 ± 1.4 vs. 8.5 ± 1.3 mm, p < 0.001), LV mass index (76.6 ± 18.2 vs. 67.9 ± 14.6 g/m², p < 0.05), and RWT (0.39 ± 0.04 vs. 0.37 ± 0.06, p < 0.005). BMI independently predicted RWT (β = 0.42, p < 0.005). Despite preserved EF, LV GLS was impaired (-22.7 ± 6.1% vs. -23.4 ± 4.2%, p < 0.01). Reduced e' medial velocity (14.0 ± 2.7 vs. 15.3 ± 2.6 cm/s, p < 0.01) was predicted solely by BMI (β = -0.62, p < 0.0001). S' decreased (13.1 ± 1.7 vs. 14.2 ± 1.6 cm/s, p < 0.01). RV free wall strain (-20.9 ± 5.2% vs. -27.6 ± 4.1%, p < 0.001) and pulmonary systolic pressure (26.6 ± 5.8 vs. 22.7 ± 4.8 mm Hg, p < 0.01) were abnormal versus controls.

Young overweight/obese individuals show early biventricular dysfunction, detectable particularly by speckle tracking, which may be more sensitive than conventional parameters and enable earlier prevention. Modest strain differences indicate long-term rather than immediate clinical relevance.