Improvement of left ventricular morphology and function in obese subjects following a diet and exercise program

The aim of this work was to compare left ventricular performance during weight reduction induced by either physical training and diet or diet alone. Forty-three moderately obese subjects received a hypocaloric diet of 800 kcal/d for 4 weeks; 22 of them were also subjected to an exercise program. By means of echocardiography, left ventricular dimensions and systolic time intervals were determined. Heart rate and blood pressure were measured at rest and during exercise. The addition of physical training resulted in a more favourable change in weight loss (-8.3 vs -6.3 kg), heart rate (-14 vs -7 bpm), systolic (-17 vs -8 mm Hg), and diastolic (-11 vs -6 mm Hg) blood pressure. Left ventricular mass (LVM) was diminished more pronounced by combined therapy (-10.0%) as compared to diet alone (-4.7%). Changes in LVM were correlated with weight loss but not with alterations in heart rate and blood pressure. Fractional shortening and mean circumferential fiber shortening velocity did not improve significantly whereas the ratio of preejection period/left ventricular ejection time (PEPi/LVETi) was shortened in the diet and diet plus exercise group by -10.7 and -17.9%, respectively. It was concluded that exercise training in combination with a hypocaloric diet reduces left ventricular dimensions, LVM and PEPi/LVETi more distinctly than diet alone.