Left ventricular diastolic and systolic function in normotensive obese subjects: influence of degree and duration of obesity

Abstract
The present study was carried out to evaluate systolic and diastolic parameters in overweight and moderately obese, but otherwise healthy subjects, and in a lean control group, to determine whether degree and duration of obesity can influence left ventricular function. A total of 27 subjects, 17 overweight or with moderate obesity and 10 lean, healthy subjects were included. Patients were divided into three groups according to their body mass index (BMI) and to Garrow's criteria as follows: lean control group (BMI < 25 kg.m−2); overweight subjects (BMI from 25 to 30kg.m−2); moderately obese subjects (BMI >30 < 40kg.m−2). Systolic and diastolic parameters were measured using blood pool gated radionuclide angiography. Left ventricular (LV) ejection fraction (EF), peak ejection rate (PER), time to PER (tPER), peak filling rate (PFR) and time to PFR (tPFR) were evaluated. PER and PFR values were normalized for end-diastolic volume (EDV). EF and PFR were significantly lower (P<0.05) both in moderately obese and in overweight subjects and tPFR was significantly (P<0.05) prolonged in both groups in comparison to lean controls. Only in moderately obese subjects was PER significantly (P < 0.05) decreased and tPER significantly (P < 0.05) prolonged in comparison to lean controls. As compared to overweight individuals, moderately obese subjects.were characterized by a significant decrease (P < 0.05) in L VEF and PER and by a significant increase (P < 0.05) in tPER, without relevant change in PFR and in tPFR. In all the obese subjects BMI was inversely correlated with PFR (r= −0.56; P<0.05) and with EF (r= −0.48; P < 0.05); duration of obesity was inversely correlated with PFR (r=- 0.64; P<0.0l) and with EF(r=- 0.51; P < 0.05). Multiple regression analysis indicated that PFR values decreased with BMI and duration of obesity, but not with mean blood pressure and L VEF. Our results indicate that diastolic abnormalities could represent the early manifestations of the effects of obesity on the heart.

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