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Cited by 713Cardiovascular Function and Risk FactorsCardiovascular Disease and AdiposityDiabetes, Cardiovascular Risks, and Lipoproteins

Alterations of Left Ventricular Myocardial Characteristics Associated With Obesity

Wong, Chiew Y., O’Moore-Sullivan, Trisha, Leano, Rodel, Byrne, Nuala, Beller, Elaine, Marwick, Thomas H.·2004·Circulation
DOI 10.1161/01.cir.0000147184.13872.0f
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Abstract

Background— Obesity is associated with heart failure, but an effect of weight, independent of comorbidities, on cardiac structure and function is not well established. We sought whether body mass index (BMI) and insulin levels were associated with subclinical myocardial disturbances. Methods and Results— Transthoracic echocardiography, myocardial Doppler-derived systolic (sm) and early diastolic velocity (em), strain and strain rate imaging and tissue characterization with cyclic variation (CVIB), and calibrated integrated backscatter (cIB) were obtained in 109 overweight or obese subjects and 33 referents (BMI <25 kg/m 2 ). BMI correlated with left ventricular (LV) mass and wall thickness ( P <0.001). Severely obese subjects (BMI >35) had reduced LV systolic and diastolic function and increased myocardial reflectivity compared with referents, evidenced by lower average long-axis strain, sm, cIB, lower CVIB, and reduced em, whereas LV ejection fraction remained normal. Differences in regional or global strain, sm, and em were identified between the severely obese (BMI >35) and the referent patients ( P <0.001). Similar but lesser degrees of reduced function by sm, em, and basal septal strain and increased reflectivity by cIB were present in overweight (BMI, 25 to 29.9) and mildly obese (BMI, 30 to 35) groups ( P <0.05). Although tissue Doppler measures were not associated with duration of obesity, they did correlate with fasting insulin levels and reduced exercise capacity. BMI was independently related to average LV strain (β=0.40, P =0.02), sm (β=−0.36, P =0.002), and em (β=−0.41, P <0.001). Conclusions— Overweight subjects without overt heart disease have subclinical changes of LV structure and function even after adjustment for mean arterial pressure, age, gender, and LV mass.

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Crossref · 10.1161/01.cir.0000147184.13872.0f

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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 [377]

  • 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 [377]

  • 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 [377]

  • 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 [377]

  • E/E′ measured at rest is normal (<10) in obese subjects.

    “E/E′ measured at rest has been reported to be normal (<10) in obese subjects (377).”

    From Cardiac remodeling in obesity (2008) · cites this paper as [377]

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Authors
Wong, C. Y., O’Moore-Sullivan, T., Leano, R., Byrne, N., Beller, E., & Marwick, T. H.
Affiliations
  • Queensland University of Technology (AU)
  • From University of Queensland (C.Y.W., T.O.-S., R.L., E.B., T.H.M.) and Queensland University of Technology (N.B.), Brisbane, Australia.
ORCID
Venue
Circulation
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2004-11-09
Volume
110
Issue
19
Pages
3081-3087
ISSN
  • 0009-7322 (ISSN-L)
  • 1524-4539
DOI
10.1161/01.cir.0000147184.13872.0f
OpenAlex
W2163335671
Cited by
713
References
26
Citations by year
2026: 7 · 2025: 14 · 2024: 13 · 2023: 35 · 2022: 31 · 2021: 28 · 2020: 35 · 2019: 31 · 2018: 26 · 2017: 43 · 2016: 50 · 2015: 36 · 2014: 40 · 2013: 50 · 2012: 37
FWCI
16.81
Type
journal article
Language
en
Open access
closed
Locations
  • Circulation (publishedVersion)
  • PubMed (publishedVersion)
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 › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Keywords
obesity, left ventricular function, myocardial strain, body mass index, insulin, tissue Doppler imaging, left ventricular mass, diastolic function, systolic function, integrated backscatter, overweight, exercise capacity
MeSH terms
Adult, Diastole, Echocardiography, Exercise Test, Female, Heart Ventricles, Humans, Insulin, Male, Middle Aged, Obesity, Stroke Volume, Systole, Echocardiography, Doppler, Observer Variation, Body Mass Index, Hypertrophy, Left Ventricular, Ventricular Dysfunction, Left

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