The Impact of Isolated Obesity on Right Ventricular Function in Young Adults

Abstract

BackgroundObesity is an independent risk factor for cardiovascular diseases. The effects of obesity on left ventricular structure and function have been reported, but relatively little is known regarding right ventricular (RV) function in obesity. ObjectiveTo evaluate subclinical RV alterations in obese, but otherwise healthy, young adults by conventional echocardiography and tissue Doppler imaging (TDI). MethodsIn this study, we included 35 normal weight healthy subjects with a body mass index (BMI) < 25 kg/m2 (group I), 27 subjects with a BMI of 30-34.99 kg/m2 (group II), and 42 subjects with a BMI ≥ 35 kg/m2 (group III). All subjects underwent transthoracic echocardiography. In addition to standard echocardiographic measurements, tricuspid annular peak systolic (Sm), peak early (Em), and late diastolic (Am) velocities, isovolumetric contraction (ICTm), relaxation (IRTm) time, and ejection time (ETm) were obtained by TDI, and RV myocardial performance index (MPIm) was calculated. ResultsIn group II, RV Em/Am was significantly decreased and IRTm and MPIm were significantly increased compared to group I (p < 0.01). RV Sm, Em, and the Em/Am ratio were significantly lower and RV IRTm and MPIm were significantly higher in group III than in group II (p < 0.05 for RV Sm and IRTm and p < 0.01 for others). RV Am differed significantly between groups III and I (p < 0.05). BMI was significantly and negatively correlated with RV Sm, Em, and the Em/Am ratio, but positively correlated with RV MPI (p < 0.01). ConclusionOur study showed that isolated obesity in young normotensive adults was associated with subclinical abnormalities in RV structure and function.

Impact of obesity on autonomic modulation, heart rate and blood pressure in obese young people

“…World Health Organization, 2003), refers to the risk of severe chronic diseases such as type II diabetes, hypertension, stroke, certain types of cancer and disorders of the ventricles, morphological changes and psychosocial damage (Melo et al, 2010;Sokmen et al, 2013;Tumuklu et al, 2007;Wong et al, 2004). It is also considered a potential predictor for cardiovascular disease and, when established early in life, leads to short and long-term damage, resulting from the abnormal lipid profile presented by these individuals (Santos et al, 2008).…”

Cardiovascular parameters in capitive blue-fronted amazon parrots (Amazona aestiva, Linnaeus, 1758) with varying body condition scores

“…Obese parrots presented reduced right ventricle (RV) length in diastole and fractional shortening (FS). In obese humans, the function of the right ventricle has been associated with the dilation of the right atrium and ventricle, as well as increased thickness of the right ventricle free wall [27].…”

“…The excess of fat tissue imposes an increase on the metabolic demand of the body, leading to a hyperdynamic circulation, structural changes (remodeling) in the right and left ventricles and, therefore, increased ventricular mass and cavity dilation. Obesity is associated with hypertrophy, dilation and diastolic dysfunction of the left ventricle and occasionally systolic dysfunction of the left ventricle [27].…”

Clinical presentation and management of right ventricular dysfunction

“…Studies have shown the presence of RV dilatation, increased RV wall thickness and subclinical RV diastolic and systolic impairment may be present in young obese patients with no pre-existing cardiovascular disease. 17 In OSA, hypoxic pulmonary vasoconstriction occurs during apnoeic episodes leading to remodelling of the pulmonary microcirculation increasing PVR, and ultimately leading to the development of PH and subsequent RV dysfunction. 18 Negative intrathoracic pressure, occurring during inspiration against an occluded pharynx, increases venous return, and RV 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 F o r P e e r R e v i e w preload.…”