Left Ventricular Systolic and Diastolic Function in Severe Obesity: A Radionuclide Study
Abstract
To verify the impact of severe obesity (defined as body mass index > 31 kg/m2) on left ventricular (LV) function, 32 asymptomatic obese but otherwise healthy subjects (16 men; age 38 ± 11 years) voluntarily underwent first-pass and equilibrium 99mTc radionuclide angiography at rest and, in 22 of them, during bicycle supine exercise. Data were compared to those obtained from 10 normal volunteers (age 48 ± 13; p < 0.05, vs. obeses). End-diastolic and stroke volumes did not differ between the two groups, whereas end-systolic volume was significantly higher in obese subjects (67 ± 20 vs. 49 ± 20 ml; p < 0.05), and, as a consequence, LV ejection fraction at rest was decreased in obese subjects (59 ± 7%) compared to normals (65 ± 6%; p < 0.05). Due to the higher heart rate in obese subjects (81 ± 13 vs. 69 ± 10 bpm, respectively; p < 0.05) cardiac output was significantly greater compared to normals (7.1 ± 0.8 vs. 6.2 ± 0.2 liters/min, respectively; p < 0.01). During exercise, ejection fraction normally increased in normals (70 ± 7%; p < 0.001, vs. baseline) but not in obese subjects (60 ± 9%; p = nonsignificant vs. baseline). In addition, systolic blood pressure/end-systolic volume ratio was significantly decreased in obese subjects (2.3 ± 1.3) compared to normals (2.8 ± 1.6; p < 0.05). Peak filling rate, normalized to end-diastolic counts per second, was significantly lower in obese subjects (2.2 ± 1.3) compared to normals (2.8 ± 1.6; p < 0.05). This difference was also true when peak filling rate was computed in stroke counts per second (3.8 ± 0.8 in obeses vs. 4.4 ± 0.4 in normals; p < 0.05). Repeat analysis in a subgroup of 10 young obese subjects (age ≤30 years) confirmed decreased ejection fraction at rest (60 ± 4%; p < 0.05) and peak filling rate (2.4 ± 0.4 end-diastolic counts/s; p < 0.05), as well as the lack of ejection fraction increase during exercise (59 ± 9%). Thus, these data indicate a subclinical impairment of LV systolic and diastolic function at rest and during exercise in asymptomatic severely obese but otherwise healthy subjects.
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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 [100]
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“Various authors have reported depressed LV ejection fraction (EF) (15, 68, 100), normal EF (22, 111, 116, 191, 242, 396 ABEL, LITWIN, AND SWEENEY”
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- Authors
- Ferraro, S., Perrone-Filardi, P., Desiderio, A., Betocchi, S., D’Alto, M., Liguori, L., Trimigliozzi, P., Turco, S., & Chiariello, M.
- Affiliations
- Federico II University Hospital (IT)
- Venue
- Cardiology
- Publisher
- S. Karger AG
- Published
- 2008-11-19
- Volume
- 87
- Issue
- 4
- Pages
- 347-353
- ISSN
- 0008-6312 (ISSN-L)
- 1421-9751
- OpenAlex
- W2039040395
- Cited by
- 67
- References
- 0
- Citations by year
- 2026: 1 · 2022: 1 · 2020: 1 · 2019: 4 · 2018: 1 · 2016: 4 · 2015: 5 · 2014: 6 · 2013: 1 · 2012: 5
- FWCI
- 3.62
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Cardiac Imaging and Diagnostics
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Keywords
- morbid obesity, left ventricular function, systolic function, diastolic function, ejection fraction, end-systolic volume, cardiac output, exercise hemodynamics, peak filling rate, heart rate, systolic blood pressure, body mass index, cardiac hypertrophy, left ventricular hypertrophy, left ventricular mass
- MeSH terms
- Adult, Diastole, Female, Hemodynamics, Humans, Male, Middle Aged, Obesity, Morbid, Radionuclide Angiography, Systole, Technetium Tc 99m Aggregated Albumin, Exercise, Radionuclide Ventriculography, Body Mass Index, Ventricular Function, Left, Ventricular Dysfunction, Left
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