EDITORIAL

Cardiac function and obesity

R S Vasan

Correspondence to:
Correspondence to:
Ramachandran S Vasan, MD, Framingham Heart Study, 73, Mt Wayte Avenue, Framingham, MA 01702, USA;
vasan@fram.nhlbi.nih.gov

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Obesity is increasing around the world, and with it the risk of cardiovascular disease

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Keywords: obesity; diastole; systole; echocardiography

The first 150 words of the full text of this article appear below.

Given the rising global epidemic of obesity,¹ it is likely that adverse health consequences of excess adiposity will escalate in the future. In this context, several investigators have described the adverse effects of obesity on the heart.^2,3 Obesity has been linked to a spectrum of cardiovascular changes ranging from a hyperdynamic circulation,² through subclinical cardiac structural changes⁴ to overt heart failure.⁵

Obesity is associated with haemodynamic overload.^2,3 The increased metabolic demand imposed by the expanded adipose tissue and augmented fat-free mass in obesity results in a hyperdynamic circulation with increased blood volume. In addition to the increased preload, left ventricular (LV) afterload is also elevated in obese individuals due to both increased peripheral resistance and greater conduit artery stiffness.⁶ Right ventricular afterload may be increased, presumably due to associated sleep disordered breathing and LV changes.³

Obesity is associated with atrial and ventricular remodelling (fig 1), known precursors of atrial . . . [Full text of this article]

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