Korean Circ J.  2008 May;38(5):270-275. 10.4070/kcj.2008.38.5.270.

The Early Change of Left Ventricular Function in Overweight and Obese Patients: Analysis With Tissue Doppler Echocardiography

• Ryu SK
• Choi JW
• Cho YB

• KMID: 2225789
• DOI: http://doi.org/10.4070/kcj.2008.38.5.270

Abstract

BACKGROUND AND OBJECTIVES: Obesity is a cause of cardiac dysfunction. We analyzed the change of diastolic function with the increase of the body mass index (BMI) for the early detection of cardiac dysfunction in overweight and obese patients. To analyze the diastolic function, we measured the mitral valve early and late diastolic inflow velocities with performing Doppler studies (E, A) and the early and late mitral annulus velocities with performing tissue Doppler studies (E', A').
SUBJECTS AND METHODS
From January 2005 to October 2007, 2,684 cases were enrolled in this study. The patients had a normal cardiac size, normal systolic function, no regional wall motion abnormalities and no significant valve disease. Those patients with a history of congenital heart disease, renal failure and congestive heart failure were excluded. The BMI was checked and Doppler echocardiographic analysis, including tissue Doppler, was done.
RESULTS
The left ventricle (LV) mass index (normal: 89.1+/-19.1, overweight: 95.7+/-18.4, obese: 97.2+/-18.9 g/m2, p<0.01), and the E/E' (8.84+/-2.81, 10.02+/-3.03, 10.84+/-3.66, respectively, p<0.01) were higher, and the E (72.4+/-16.7, 68.6+/-16.0, 71.5+/-17.0 cm/sec, respectively, p<0.01), and E' (8.78+/-2.77, 7.27+/-2.19, 7.17+/-2.62 cm/sec, respectively, p<0.01) were lower in the overweight (BMI> or =25 kg/m2) and obese groups (BMI> or =30 kg/m2) than that of the normal group. On multiple logistic regression analysis, overweight was an independent risk factor for diastolic dysfunction with considering other risk factors such as hypertension, diabetes mellitus, age and gender. The risk of LV diastolic dysfunction was increased 2.13 times in the overweight group and 3.1 times in the obese group as compared with the normal group.
CONCLUSION
With an increase of weight, diastolic function was worsened before the development of systolic dysfunction. This change was apparent in the overweight group. Tissue Doppler study on the mitral annulus is more sensitive to detect the change of diastolic function in overweight and obese patients.

Keyword

Obesity; Echocardiography; Ventricular function

MeSH Terms

Body Mass Index
Diabetes Mellitus
Echocardiography
Echocardiography, Doppler
Heart Diseases
Heart Failure
Heart Ventricles
Humans
Hypertension
Logistic Models
Mitral Valve
Obesity
Overweight
Renal Insufficiency
Risk Factors
Ventricular Function
Ventricular Function, Left

Figure

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  Fig. 1 Correlation between BMI and the various parameters of LV diastolic function (Pearson correlation analysis, r: Pearson correlation coefficient). BMI: body mass index, LV: left ventricle.

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