Abstract 12902: The Influences of Obesity on Cardiac Remodeling, Geometric Alteration and Diastolic Patterns in a Large Asian Population With Preserved Ejection Fraction
Introduction: Metabolic syndrome associated with excessive body weight and size is a key feature of preserved ejection fraction heart failure. The aim of this study is to evaluate the potential impact of body-mass index (BMI) on various aspects of cardiac structural and functional disturbances.
Hypothesis: We assess the hypothesis that obesity has independent negative effects on cardiac structure and function.
Methods: We consecutively assessed 5919 particants of a cardiovascular health survey in which interval echo-derived Tissue Doppler Imaging (TDI) was available. Conventional two-dimensional images, hemodynamic Doppler were all obtained as well, with structured questionnaire performed. Early mitral inflow velocity (E) divided by TDI early-diastolic velocity (E') was used for the evaluation of left ventricular (LV) filling pressure. Anthropometric BMI was categorized according to international cutoff points set by World Health Organization.
Results: With graded increases in BMI, there was a trend toward larger LA and LV diameter, greater LV wall thickness, decreased mitral inflow E velocity, prolonged isovolumetric relaxation time (IVRT), decreased lateral and septal E’ velocities, and elevated E/E’ ratio. After adjusting for age, gender, blood pressure and clinical variables, these differences remained markedly significant among nearly all components except for mitral E velocity (all p<0.001), whereas LV ejection fraction remained within normal range.
Conclusions: Obesity may play a role in the pathogenesis of LV diastolic dysfunction, resulting in left atrial enlargement and elevated filling pressures. These functional abnormalities may partially explain the mechanisms underlying preserved ejection fraction heart failure.
Author Disclosures: Y. Lai: None. K. Sung: None. J. Kuo: None. J. Hou: None. H. Yeh: None. C. Hung: None.
- © 2014 by American Heart Association, Inc.