Alterations in left ventricular structure and function in young healthy obese women
Open accessAbstract
Objectives This study was designed to determine the effects of obesity on left ventricular (LV) structure and function in young obese women.Background Severe prolonged obesity in older adults results in increased plasma volume, eccentric LV hypertrophy, and systolic and diastolic dysfunction. Obese women are at increased risk for the development of heart failure. However, the effects of the obesity on cardiac structure and function in young, otherwise-healthy women are controversial.Methods Fifty-one women were evaluated: 20 were obese (body mass index [BMI] > or =30 kg/m(2)) and 31 were non-obese (BMI <30 kg/m(2)). Left ventricular structure and systolic and diastolic function were assessed by two-dimensional echocardiography and tissue Doppler imaging, including the load-independent systolic myocardial velocity (Sm global) and early diastolic myocardial velocity (Em global), respectively. The effects of BMI on LV structure and function were assessed using multivariate regression analyses.Results Obese women had higher end-diastolic septal and posterior wall thickness, LV mass, and relative wall thickness than non-obese women; BMI values showed significant correlations with these variables (r = 0.58, p < 0.0001; r = 0.50, p < 0.0002; r = 0.52, p < 0.0001, and r = 0.40, p < 0.005, respectively). The Sm global and Em global were lower in obese women, suggesting systolic and diastolic function are decreased; both were negatively correlated with BMI (r = -0.43, p <. 002 and r = -0.61, p < 0.0001, respectively). Multivariate analysis showed BMI was the only independent predictor of relative wall thickness, Sm global, and Em global.Conclusions Obesity in young otherwise-healthy women is associated with concentric LV remodeling and decreased systolic and diastolic function. These early abnormalities in LV structure and function may have important implications for explaining the myocardial dysfunction that is associated with increased cardiovascular morbidity and mortality caused by obesity.
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Both LV cavity size and wall thickness are increased in obese subjects compared with age-matched controls.
“In addition, the results indicate that both LV cavity size and wall thickness are increased in obese subjects compared with age-matched controls (22, 134, 151, 156, 242, 279, 377).”
From Cardiac remodeling in obesity (2008) · cites this paper as [279]
Many published studies have concluded that obesity is independently associated with LV hypertrophy.
“Many published studies have concluded that obesity is independently associated with LV hypertrophy (22, 28, 63, 72, 116, 235, 242, 266, 279, 284, 377).”
From Cardiac remodeling in obesity (2008) · cites this paper as [279]
More recent data confirm the increased prevalence of LV hypertrophy in obese subjects.
“The more recent data confirm the increased prevalence of LV hypertrophy in obese subjects.”
From Cardiac remodeling in obesity (2008) · cites this paper as [279]
Obese subjects have generally been found to have subclinical contractile abnormalities when assessed with sensitive techniques.
“Indeed, obese subjects have generally been found to have subclinical contractile abnormalities when assessed with the aforementioned techniques (21, 22, 71, 279, 377).”
From Cardiac remodeling in obesity (2008) · cites this paper as [279]
E-wave deceleration times have been reported to be increased or unchanged in obese subjects.
“Similarly, E-wave deceleration times have been reported to be increased (274) or unchanged (279) in obese subjects.”
From Cardiac remodeling in obesity (2008) · cites this paper as [279]
Findings on LV ejection fraction in obese subjects are variable, with studies reporting depressed, normal, or supernormal EF.
“Various authors have reported depressed LV ejection fraction (EF) (15, 68, 100), normal EF (22, 111, 116, 191, 242, 266, 279, 377), and supernormal EF (28, 155, 274, 375) in obese subjects.”
From Cardiac remodeling in obesity (2008) · cites this paper as [279]
LV ejection fraction is normal or even supranormal in the majority of obese subjects, even those with severe obesity.
“More recently, however, several studies have found that LV ejection fraction is normal or even supranormal in the majority of obese subjects, even those with severe obesity (22, 28, 155, 191, 242, 274, 279, 375, 377).”
From Cardiac remodeling in obesity (2008) · cites this paper as [279]
Some studies have found reduced early diastolic (E-wave) velocities while others have found them unchanged in obese subjects.
“Some studies have found reduced early diastolic (E-wave) velocities (155) while others have found them to be unchanged (242, 266, 274, 279, 314).”
From Cardiac remodeling in obesity (2008) · cites this paper as [279]
At least two groups have reported evidence of reduced early diastolic tissue velocities and diastolic strain rate in obese compared with normal-weight subjects.
“Using these approaches, at least two groups have reported evidence of reduced early diastolic tissue velocities and diastolic strain rate in obese compared with normal-weight subjects (279, 377).”
From Cardiac remodeling in obesity (2008) · cites this paper as [279]
Late diastolic (A-wave) velocities have been reported to be increased or unchanged in obese subjects.
“Lastly, late diastolic (A-wave) velocities have been reported to be increased (28, 155, 242) or unchanged (266, 274, 279, 314).”
From Cardiac remodeling in obesity (2008) · cites this paper as [279]
Multiple recent studies have shown a predominance of concentric geometry in obese patients.
“Unfortunately, this relatively straightforward and logical hypothesis is complicated by the fact that multiple recent studies have shown a predominance of concentric geometry in obese patients (22, 63, 72, 279, 377).”
From Cardiac remodeling in obesity (2008) · cites this paper as [279]
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- Authors
- Peterson, L. R., Waggoner, A. D., Schechtman, K. B., Meyer, T., Gropler, R. J., Barzilai, B., & Dávila-Román, V. G.
- Affiliations
- Washington University in St. Louis (US)
- Corresponding author
- Peterson, Linda R
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2004-04
- Volume
- 43
- Issue
- 8
- Pages
- 1399-1404
- ISSN
- 0735-1097 (ISSN-L)
- OpenAlex
- W2126975783
- Cited by
- 449
- References
- 28
- Citations by year
- 2026: 4 · 2025: 8 · 2024: 7 · 2023: 13 · 2022: 16 · 2021: 14 · 2020: 15 · 2019: 13 · 2018: 15 · 2017: 22 · 2016: 28 · 2015: 21 · 2014: 30 · 2013: 25 · 2012: 25
- FWCI
- 17.21
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute on Aging (R01 AG 15466, R01AG015466)
- National Heart, Lung, and Blood Institute (P01-HL13581, R01 HL 58878, R01HL058878, R01HL071782, K24 HL67002, R01HL71782, K24HL067002)
- National Center for Research Resources (M01-RR00036, M01RR000036)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (5K12HD145902)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Disease and Adiposity
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Effects of Exercise
- Keywords
- obesity, left ventricular structure, left ventricular function, young women, body mass index, concentric remodeling, left ventricular hypertrophy, systolic dysfunction, diastolic dysfunction, myocardial velocity, heart failure risk
- MeSH terms
- Adult, Diastole, Echocardiography, Female, Heart Ventricles, Humans, Obesity, Body Mass Index, Multivariate Analysis, Ventricular Function, Ventricular Dysfunction, Left, Ventricular Remodeling
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