Relation of insulin resistance to left ventricular hypertrophy and diastolic dysfunction in obesity

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Abstract
OBJECTIVE: To assess relations of left ventricular (LV) geometry and function to insulin resistance in obesity – a condition associated with volume overload and abnormal LV relaxation. DESIGN: Cross-sectional relational study. SUBJECTS: 27 healthy overweight–obese subjects (18 women, body mass index (BMI)=35.0±4.0 kg/m2) and 31 age-matched normal-weight controls (21 women, BMI=22.6±2.4 kg/m2). MEASUREMENTS: Subjects were studied by Doppler-echocardiography the same day and hour (08.00 h) as measurements of fasting insulin and blood glucose were made. Insulin resistance was determined by the ‘Homeostasis Assessment Model’. RESULTS: Twelve obese subjects with insulin resistance (IR) had higher body size than 15 patients without IR and higher blood pressure than normal-weight controls (all Pr=0.44) and obese without IR (r=0.62) but not in insulin resistant subjects (r=0.14). CONCLUSION: IR does not independently influence myocardial relaxation in uncomplicated obesity, but modulates the effect of load on active diastole.

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