Effects of isolated obesity on systolic and diastolic left ventricular function

Pascual, María José; Pascual, Domingo; Soria, Federico; Vicente, T; Hernandez, Antonieta; Tébar, Francisco Javier; Valdés, Mariano

doi:10.1136/heart.89.10.1152

Cited by 281 publications

(295 citation statements)

References 29 publications

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“…These results challenge previous findings 7,9,26 and support more recent literature, 4,11,12,22,24 probably because of the use of newer and more sensitive echocardiographic techniques rather than conventional echocardiographic measurements, such as left-ventricular ejection fraction and fractional shortening, which are relatively insensitive, and thus unable to detect early preclinical changes in left-ventricular function.…”

Section: Left-ventricular Morphology and Systolic Functionsupporting

confidence: 56%

“…Moreover, the manner and the extension of the negative influence of obesity on the diastolic and/or systolic function in the left and right ventricle remains debated and unclear. [6][7][8][9][10][11][12][13] To the best of our knowledge, this study represents the first attempt to perform such a complete and detailed echocardiographic evaluation to determine the existence and the extent of an obesityrelated adjunctive depressive effect on left-and right systo-diastolic ventricular dysfunction in hypertensive patients with cutting-edge diagnostic techniques, such as tissue Doppler velocity and strain imaging.…”

Section: Diffusion and Accuracy Confirmation Of Tissue Doppler Imaginmentioning

confidence: 99%

“…4 Moreover, obesity has been associated with heart failure, 5 left-ventricular dilation, increased leftventricular wall stress and compensatory (eccentric) left-ventricular hypertrophy. 6,7 Impairment of cardiac function has been reported to correlate with BMI and the duration of obesity, 7,8 with most studies demonstrating abnormal diastolic function, 9,10 without a consistent association with systolic dysfunction. 7,8 A condition characterized by chronic leftventricular volume overload, eccentric hypertrophy and progressive diastolic impairment, commonly leading to heart failure, have also been described as a unique entity named 'obesity cardiomyopathy' .…”

Section: Introductionmentioning

confidence: 99%

“…6,7 Impairment of cardiac function has been reported to correlate with BMI and the duration of obesity, 7,8 with most studies demonstrating abnormal diastolic function, 9,10 without a consistent association with systolic dysfunction. 7,8 A condition characterized by chronic leftventricular volume overload, eccentric hypertrophy and progressive diastolic impairment, commonly leading to heart failure, have also been described as a unique entity named 'obesity cardiomyopathy' . 6 Indeed, obesity has been linked to a spectrum of more minor cardiovascular changes, ranging from hyperdynamic circulation to sub-clinical cardiac structural changes.…”

Section: Introductionmentioning

confidence: 99%

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Obesity-related adjunctive systo–diastolic ventricular dysfunction in patients with hypertension: echocardiographic assessment with tissue Doppler velocity and strain imaging

et al. 2011

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Very few data exist regarding the effect of obesity on both left and right systo-diastolic ventricular function in hypertensive patients. Therefore, the aim of this study was to determine the existence and extent of an obesity-related adjunctive depressive effect on left-and right-ventricular systo-diastolic dysfunction. This study compared non-obese with obese hypertensive patients and evaluated left-and right-ventricular morphological and functional parameters by means of conventional echocardiography and by two new sensitive echocardiographic techniques: tissue Doppler velocity and strain imaging. We selected 248 hypertensive patients and divided them into four groups according to increasing body mass index (BMI). All patients underwent a clinical history and examination and transthoracic echocardiography, including conventional echocardiographic evaluation and tissue Doppler velocity and strain imaging measurements. Conventional echocardiographic evaluation did not reveal an association between ventricular systo-diastolic dysfunction and increasing BMI. In contrast, tissue Doppler velocity and strain imaging measurements emphasized the negative influence of obesity. For measurements in both the left and right ventricle, myocardial early peak diastolic velocities (E m ), the ratio of myocardial early-to-late peak diastolic velocity (E m /A m ), myocardial peak systolic velocities (S m ), and peak strain and strain rate values significantly decreased with increasing BMI (Po0.01 for all parameters measured), even after adjusting for potential confounding variables. In conclusion, by means of new more sensitive echocardiographic techniques, our study clearly demonstrated the negative impact of obesity on both left-and right-ventricular systo-diastolic function, in terms of adjunctive sub-clinical worsening, in hypertensive patients.

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Section: Left-ventricular Morphology and Systolic Functionsupporting

confidence: 56%

Section: Diffusion and Accuracy Confirmation Of Tissue Doppler Imaginmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Obesity-related adjunctive systo–diastolic ventricular dysfunction in patients with hypertension: echocardiographic assessment with tissue Doppler velocity and strain imaging

et al. 2011

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“…7 Indeed, long-standing obesity can induce left ventricular structural and functional abnormalities, characterized by volume overload and hyperdynamism, eccentric left ventricular hypertrophy, diastolic dysfunction and, occasionally, systolic dysfunction and heart failure. 8 Pulsed-Wave Tissue Doppler Imaging (PW-TDI) of the mitral annulus has demonstrated the capability to a relatively load-independent analysis of the global longitudinal myocardial 9,10 Color-Doppler Myocardial Imaging (CDMI) echocardiography-derived strain rate (SR) and strain measurements are new quantitative indices of regional intrinsic myocardial deformation. 11,12 In particular, strain and SR are relatively load independent, and this characteristic is very relevant in the obese population, in which a cardiac volume overload exists.…”

Section: Introductionmentioning

confidence: 99%

Relationship between preclinical abnormalities of global and regional left ventricular function and insulin resistance in severe obesity: a Color Doppler Imaging Study

et al. 2006

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Background: The aim of this study was to evaluate the relationship between insulin resistance and preclinical abnormalities of the left ventricular structure and function detected in severe obesity by Color Doppler Myocardial Imaging (CDMI). Forty-eight consecutive severely obese patients (Group O) (11 males, 37 females, mean age 32.877 years) were enrolled. Forty-eight sexand age-matched non-obese healthy subjects were also recruited as controls (Group C). All subjects underwent conventional 2D-Color Doppler echocardiography and CDMI. The homeostasis model assessment insulin resistance index (HOMA-IR) was used to assess insulin resistance results. Obese subjects had a greater left ventricular mass index (by height) (58.8714 g/m 2.7 ) than controls (3778 g/m 2.7 ) (Po0.0001), owing to compensation response to volume overload caused by a greater cardiac output (Po0.02). Preload reserve was increased in obese subjects, as demonstrated by a significant increase in left atrial dimension (Po0.0001). Obese patients had a slightly reduced LV diastolic function (transmitral E/A ratio: Group O, 1.170.8 vs Group C, 1.5 70.5; Po0.002). Cardiac deformation assessed by regional myocardial systolic strain and strain rate (SR) values was significantly lower (abnormal) in obese patients than in controls, both at the septum and lateral wall level. These strain and SR abnormalities were significantly related to body mass index. In addition, the early phase of diastolic function, evaluated using SR, was compromised in obese patients (Po0.001). The HOMA-IR values in obese patients were significantly higher (3.0971.6) than those determined in the control group (0.9270.5) (Po0.0001). The HOMA-IR values, in the obese group, were significantly related to systolic strain and SR values sampled at the septum level (Po0.0001). Conclusion: In conclusion, this study has demonstrated that obese patients pointed out systolic structural and functional abnormalities at a preclinical stage, in particular through strain and SR analysis; on the other hand, those altered CDMI parameters well distinguish obese subjects as compared with the control group. Furthermore, another main finding of the study was that myocardial deformation (systolic strain) could have a correlation with insulin resistance level.

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Using Myocardial Imaging to Identify and Manage Subclinical Heart Disease in Diabetes Mellitus and Obesity

Andersen¹

2007

Myocardial Imaging: Tissue Doppler and Speckle Tracking

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Effects of isolated obesity on systolic and diastolic left ventricular function

Cited by 281 publications

References 29 publications

Obesity-related adjunctive systo–diastolic ventricular dysfunction in patients with hypertension: echocardiographic assessment with tissue Doppler velocity and strain imaging

Obesity-related adjunctive systo–diastolic ventricular dysfunction in patients with hypertension: echocardiographic assessment with tissue Doppler velocity and strain imaging

Relationship between preclinical abnormalities of global and regional left ventricular function and insulin resistance in severe obesity: a Color Doppler Imaging Study

Using Myocardial Imaging to Identify and Manage Subclinical Heart Disease in Diabetes Mellitus and Obesity

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