Abstract 15593: Impact of Obesity and Overweight on Left Ventricular Diastolic Function in a Community Cohort
Background: Obesity and overweight are predictors of incident heart failure. Left ventricular (LV) diastolic dysfunction is an asymptomatic condition associated with future occurrence of heart failure. It is not clear whether obesity and overweight are associated with LV diastolic dysfunction independent of risk factors often clustering with both conditions.
Methods and Results: LV diastolic function was evaluated in 822 participants from the Cardiovascular Abnormalities and Brain Lesions Study and Northern Manhattan Study by Doppler flow analysis and tissue Doppler imaging. Peak early and late trans-mitral diastolic flow velocities (E, A) and early diastolic mitral annulus velocity (E') were measured, and E/A and E/E' were calculated. The study sample was divided into three groups: lean (BMI lower than 25.0 kg/m2), overweight (BMI 25.0–29.9) and obese (BMI greater than or equal to 30.0). Obese and overweight subjects had higher LV mass, and greater prevalence of hypertension and diabetes than lean subjects (all p<0.05). In multivariate analyses adjusted for age, sex, heart rate, LV mass, hypertension and diabetes, increasing BMI was associated with higher E (beta=0.11), A (beta=0.16), and E/E', an indicator of LV filling pressure (beta=0.10, all p<0.01). Diastolic function parameters in each group are shown in the table (mean values adjusted for age, LV mass and heart rate; standard errors in parentheses). The risk of diastolic dysfunction was significantly higher in overweight [adjusted odds ratio (OR): 1.66, 95% confidence intervals (CI) 1.11–2.50] and obese subjects (adjusted OR: 1.92, 95% CI 1.24–2.95) compared to the lean group.
Conclusions: An increased BMI is associated with worse LV diastolic function and increased LV filling pressure, independent of cardiovascular risk factors. The increased risk of LV diastolic dysfunction in overweight and obese subjects may partly account for the increased risk of heart failure associated with both conditions.
- © 2010 by American Heart Association, Inc.