Severe Obesity Impairs Systolic and Diastolic Heart Function – The Significance of Pulsed Tissue Doppler, Strain, and Strain Rate Parameters

Wierzbowska−Drabik, Karina; Chrzanowski, Łukasz; Kapusta, Anna; Uznańska‐Loch, Barbara; Płońska, Edyta; Krzemińska‐Pakuła, Maria; Kurpesa, Małgorzata; Rechciński, Tomasz; Trzos, Ewa

doi:10.1111/echo.12164

Cited by 24 publications

(16 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A reduction of the e¢-wave velocity in people with obesity has also been reported in other studies 15,21…”

Section: Discussionsupporting

confidence: 80%

Improvement of impaired diastolic left ventricular function after diet-induced weight reduction in severe obesity

Karimian¹,

Stein²,

Bauer³

et al. 2017

DMSO

View full text Add to dashboard Cite

Background/objectivesObesity is independently associated with left ventricular (LV) diastolic dysfunction and altered cardiac morphology. Morbidity and mortality in patients with diastolic dysfunction are similar to values observed in patients with systolic heart failure. We hypothesized that dysfunctional cardiac responses in people with obesity are reversible after weight loss. Thus, we studied the effect of dietary weight reduction on LV diastolic function as well as on cardiac structure using transthoracic echocardiography and tissue Doppler imaging (TDI).Subjects/methodsThirty-two subjects with obesity underwent a 12-week low-calorie fasting phase of a formula diet. Echocardiographic tissue Doppler indices of diastolic function and measurements of cardiac size were obtained prior to and after the fasting phase.ResultsA 12-week diet significantly reduced body mass index from 40.3 ± 6.6 kg/m2 to 33.2 ± 6.1 kg/m2 (p < 0.01). Weight loss was associated with a significant reduction in blood pressure and heart rate. Echocardiography revealed diastolic dysfunction in subjects with obesity, which was improved by dieting. After weight loss, trans-mitral Doppler echocardiography showed a significant reduction in A-wave velocity, from 65.8 ± 19.2 cm/s to 57.0 ± 16.8 cm/s, and an increase in E/A ratio from 1.2 ± 0.4 to 1.4 ± 0.5 (p < 0.01). TDI displayed a significantly lower a′-wave velocity (10.3 ± 2.3 cm/s and 8.9 ± 1.7 cm/s; p < 0.01). Left atrial and LV dimensions were normal and remained unchanged after weight loss.ConclusionObesity is associated with diastolic dysfunction. A 12-week low-calorie diet with successful weight loss can reduce blood pressure and heart rate and partially normalize diastolic dysfunction.

show abstract

“…A reduction of the e¢-wave velocity in people with obesity has also been reported in other studies 15,21…”

Section: Discussionsupporting

confidence: 80%

Improvement of impaired diastolic left ventricular function after diet-induced weight reduction in severe obesity

Karimian¹,

Stein²,

Bauer³

et al. 2017

DMSO

View full text Add to dashboard Cite

show abstract

“…An association between BMI and LA function has been previously described [21–23]. In our study, the use of MRI enabled the quantification of LA function, LV intra-myocardial and epicardial fat during the same examination.…”

Section: Discussionmentioning

confidence: 63%

Impact of obesity and epicardial fat on early left atrial dysfunction assessed by cardiac MRI strain analysis

Evin

Broadhouse

Callaghan

et al. 2016

Cardiovasc Diabetol

View full text Add to dashboard Cite

Background: Diastolic dysfunction is a major cause of morbidity in obese individuals. We aimed to assess the ability of magnetic resonance imaging (MRI) derived left atrial (LA) strain to detect early diastolic dysfunction in individuals with obesity and type 2 diabetes, and to explore the association between cardiac adipose tissue and LA function.Methods: Twenty patients with obesity and T2D (55 ± 8 years) and nineteen healthy controls (48 ± 13 years) were imaged using cine steady state free precession and 2-point Dixon cardiovascular magnetic resonance. LA function was quantified using a feature tracking technique with definition of phasic longitudinal strain and strain rates, as well as radial motion fraction and radial velocities.Results: Systolic left ventricular size and function were similar between the obesity and type 2 diabetes and control groups by MRI. All patients except four had normal diastolic assessment by echocardiography. In contrast, measures of LA function using magnetic resonance feature tracking were uniformly altered in the obesity and type 2 diabetes group only. Although there was no significant difference in intra-myocardial fat fraction, Dixon 3D epicardial fat volume(EFV) was significantly elevated in the obesity and type 2 diabetes versus control group (135 ± 31 vs. 90 ± 30 mL/m 2 , p < 0.001). There were significant correlations between LA functional indices and both BMI and EFV (p ≤ 0.007).Conclusions: LA MRI-strain may be a sensitive tool for the detection of early diastolic dysfunction in individuals with obesity and type 2 diabetes and correlated with BMI and epicardial fat supporting a possible association between adiposity and LA strain.

show abstract

“…Identifying which SRe parameter is the most sensitive index of LV diastolic function in obesity has been controversial (22,23). The potential reasons for discrepancy in recent studies include sample size, population characteristics, and methodological differences in the assessment of myocardial deformation.…”

Section: Discussionmentioning

confidence: 99%

Association of Obesity in Early Adulthood and Middle Age With Incipient Left Ventricular Dysfunction and Structural Remodeling

Kishi

Armstrong

Gidding

et al. 2014

JACC: Heart Failure

View full text Add to dashboard Cite

Objectives We investigated the relationship of body mass index (BMI) and its 25-year change to left ventricular (LV) structure and function. Background Longstanding obesity may be associated with clinical cardiac dysfunction and heart failure. Whether obesity relates to cardiac dysfunction during young adulthood and middle age has not been investigated. Methods The Coronary Artery Risk Development in Young Adults (CARDIA) enrolled white and black adults aged 18-30 years in 1985-86 (Year-0). At the Year-25, cardiac function was assessed by conventional echocardiography, tissue Doppler imaging (TDI), and speckle tracking echocardiography (STE). Twenty-five year change in BMI (classified as Low:<27 Kg/m2 and High:≥27 Kg/m2) was categorized into four groups (Low-Low, High-Low, Low-High, and High-High). Multiple linear regression was used to quantify the association between categorical changes in BMI (Low-Low as reference) with LV structural and functional parameters obtained in middle age, adjusting for baseline and 25-year change in risk factors. Results The mean BMI was 24.4 kg/m2 in 3,265 participants included at Year-0. Change in BMI adjusted for risk factors was directly associated with incipient myocardial systolic dysfunction assessed by STE (High-High:β-coefficient=0.67; Low-High:β-coefficient=0.35 for longitudinal peak-systolic strain) and diastolic dysfunction assessed by TDI (High-High:β-coefficient=-074; Low-High:β-coefficient=-0.45 for e′) and STE (High-High:β-coefficient= -0.06 for circumferential early-diastolic strain rate). Greater BMI was also significantly associated with increased LV mass/height (High-High:β-coefficient=26.11; Low-High:β-coefficient=11.87). Conclusions Longstanding obesity from young adulthood to middle age is associated with impaired LV systolic and diastolic function assessed by conventional echocardiography, TDI, and STE in a large bi-racial cohort of adults aged 43-55 years.

show abstract

Severe Obesity Impairs Systolic and Diastolic Heart Function – The Significance of Pulsed Tissue Doppler, Strain, and Strain Rate Parameters

Abstract: TDE parameters documented reduced systolic and diastolic function of both ventricles in obese patients. 2-dimensional speckle tracking analysis revealed that circumferential and radial but not longitudinal strain and SR were impaired in the obese group.

Cited by 24 publications

References 36 publications

Improvement of impaired diastolic left ventricular function after diet-induced weight reduction in severe obesity

Improvement of impaired diastolic left ventricular function after diet-induced weight reduction in severe obesity

Impact of obesity and epicardial fat on early left atrial dysfunction assessed by cardiac MRI strain analysis

Association of Obesity in Early Adulthood and Middle Age With Incipient Left Ventricular Dysfunction and Structural Remodeling

Contact Info

Product

Resources

About