Influence of Excess Fat on Cardiac Morphology and Function: Study in Uncomplicated Obesity

Iacobellis, Gianluca; Ribaudo, Mária Cristina; Leto, Gaetano; Zappaterreno, Alessandra; Vecci, E; Mario, U. Di; Leonetti, Frida

doi:10.1038/oby.2002.104

Cited by 214 publications

(177 citation statements)

References 35 publications

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“…Finally, we know that severely obese subjects can present with high LVM and impaired diastole (22,23). In this study, we found that the weight loss significantly decreased LVM and improved diastolic function.…”

confidence: 55%

Substantial Changes in Epicardial Fat Thickness After Weight Loss in Severely Obese Subjects

Iacobellis

Singh

Wharton

et al. 2008

Obesity

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206

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We sought to evaluate the effect of weight loss on echocardiographic epicardial fat thickness, as index of visceral adiposity, and whether epicardial fat change after the weight loss can be proportionally different from overall body weight changes and related to cardiac parameters changes in severely obese subjects. This was an interventional study in 20 severely obese subjects (12 women, 8 men, BMI 45 ± 5 kg/m 2 , 35 ± 10 years) who underwent 6-month very low calorie diet weight loss program. Baseline and after 6-month weight loss anthropometrics, echocardiographic epicardial fat thickness, left ventricular mass (LVM), and diastolic function parameters were assessed. Subjects lost 20% of original body weight, BMI reduced by 19% of original BMI, waist circumference decreased by 23% of initial waist circumference. Epicardial fat thickness decreased from 12.3 ± 1.8 to 8.3 ± 1 mm P < 0.001 after the 6-month very low calorie diet, as −32% of baseline epicardial fat thickness. LVM and diastolic function changes were better correlated with epicardial fat changes. We showed that significant weight loss can be associated with significant reduction in the epicardial fat thickness, marker of visceral adiposity in severely obese subjects. Epicardial fat decrease, therefore visceral fat decrease, can be proportionally higher than overall adiposity decrease. Epicardial fat changes are significantly associated with obesity-related cardiac morphological and functional changes during weight loss. Measurement of echocardiographic epicardial fat thickness may provide an additional tool in understanding the metabolic risk associated with variation in fat distribution.

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confidence: 55%

Substantial Changes in Epicardial Fat Thickness After Weight Loss in Severely Obese Subjects

Iacobellis

Singh

Wharton

et al. 2008

Obesity

Self Cite

206

164

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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 Functioncontrasting

confidence: 50%

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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“…[21][22][23] Atrial and ventricular remodeling are common in obese patients, and it is known that these physiopathological aspects are related to atrial and ventricular dysfunctions. The larger atrial size in obese subjects is related to an expanded intravascular volume and to altered left ventricular filling properties.…”

Section: Discussionmentioning

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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Influence of Excess Fat on Cardiac Morphology and Function: Study in Uncomplicated Obesity

Cited by 214 publications

References 35 publications

Substantial Changes in Epicardial Fat Thickness After Weight Loss in Severely Obese Subjects

Substantial Changes in Epicardial Fat Thickness After Weight Loss in Severely Obese Subjects

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

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