Obesity related changes in cardiac structure and function: role of blood pressure and metabolic abnormalities

Acta Cardiol. 2020 Sep;75(5):413-420. doi: 10.1080/00015385.2019.1598638. Epub 2019 Apr 24.

Abstract

Background: It has been reported that changes in cardiac structure and ventricular function associated with obesity have to be attributable to hemodynamic and non-hemodynamic alterations. Accordingly, the aim of this was to evaluate left ventricular hypertrophy (LVH) prevalence and its effect on left ventricular systolic and diastolic function in a cohort of obese patients.Materials and Methods: LV internal diameter (LVID), left ventricular mass (LVM) and LVM/height2.7(LVMI), relative wall thickness (RWT), LV ejection fraction (LVEF), E/A ratio, isovolumic relaxation time, deceleration time of E velocity by echocardiography and pulsed-wave Doppler and total circulating adiponectin (ADPN) by radioimmunoassay were measured in 319 obese subjects with and without LVH.Results: Increased values of BMI, WHR, SBP, DBP, MBP LVID, LVM, LVMI, IVST (p < .001), increased prevalence of subjects with LVEF< 50%,(p < .001), central fat distribution (p < .001), hypertension (p < .001), diabetes (p < .001), metabolic syndrome (p < .02), and reduced value of ADPN (p < .0001) and LVEF (p < .001) were detected in LVH obese subjects than controls without LVH. No significant differences in diastolic parameters were observed between the two groups. LVEF correlated directly with ADPN (p < .0001) and inversely with age (p < .01), BMI (p < .01), WHR (p < .001), MBP (p < .01) MetS (p < .02) and LVMI (p < .001). WHR, MBP, LVMI and ADPN were independently associated with LVEF.Conclusions: In conclusion, our data indicate that obese subjects with LVH might be considered a distinct phenotype of obesity, characterised by LVH, increased prevalence of cardiometabolic comorbidities, central fat distribution, hypoadiponectinemia and early left ventricular systolic dysfunction.

Keywords: Obesity; adiponectin; hypertension; left ventricular hypertrophy; waist to hip ratio.

MeSH terms

  • Adiponectin / blood*
  • Cardiometabolic Risk Factors
  • Correlation of Data
  • Echocardiography / methods
  • Echocardiography, Doppler, Pulsed / methods
  • Female
  • Heart Ventricles* / diagnostic imaging
  • Heart Ventricles* / pathology
  • Humans
  • Hypertrophy, Left Ventricular* / diagnosis
  • Hypertrophy, Left Ventricular* / epidemiology
  • Hypertrophy, Left Ventricular* / etiology
  • Hypertrophy, Left Ventricular* / physiopathology
  • Italy / epidemiology
  • Male
  • Middle Aged
  • Obesity* / complications
  • Obesity* / diagnosis
  • Obesity* / metabolism
  • Obesity* / physiopathology
  • Organ Size
  • Phenomics / methods
  • Stroke Volume
  • Ventricular Dysfunction, Left* / diagnosis
  • Ventricular Dysfunction, Left* / etiology

Substances

  • Adiponectin