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Effects of isolated obesity on systolic and diastolic left ventricular function
  1. M Pascual1,
  2. D A Pascual2,
  3. F Soria2,
  4. T Vicente3,
  5. A M Hernández1,
  6. F J Tébar1,
  7. M Valdés2
  1. 1Endocrinology and Nutrition Department, University Hospital Virgen de la Arrixaca, Murcia, Spain
  2. 2Cardiology Department, University Hospital Virgen de la Arrixaca
  3. 3Cardiology Department, General University Hospital, Murcia, Spain
  1. Correspondence to:
    Dr Mariano Valdés, C/Portillo San Antonio 8, 5° D, 30005 Murcia, Spain;


Background: Obesity is associated with increased cardiovascular morbidity and mortality. A direct effect of isolated obesity on cardiac function is not well established.

Objective: To determine the direct effect of different grades of isolated obesity on echocardiographic indices of systolic and diastolic left ventricular function.

Methods: 48 obese and 25 normal weight women were studied. They had no other pathological conditions. Obesity was classed as slight (n = 17; body mass index (BMI) 25–29.9 kg/m2), moderate (n = 20; BMI 30–34.9 kg/m2), or severe (n = 11; BMI ⩾ 35 kg/m2). Echocardiographic indices of systolic and diastolic function were obtained, and dysfunction was assumed when at least two values differed by ⩾ 2 SD from the normal weight group.

Results: Ejection fraction (p < 0.05), fractional shortening (p < 0.05), and mean velocity of circumferential shortening (p < 0.05) were increased in slight and moderate obesity. Left ventricular dimensions were increased (p < 0.001) but relative wall thickness was unchanged. No obese patients met criteria for systolic dysfunction. In obese subjects, the mitral valve pressure half time (p < 0.01) and the left atrial diameter (p < 0.001) were increased and the deceleration slope was decreased (p < 0.01); all other diastolic variables were unchanged. No differences were found between obesity subgroups. Subclinical diastolic dysfunction was more prevalent among obese subjects (p = 0.002), being present in two with slight obesity (12%), seven with moderate obesity (35%), and five with severe obesity (45%). BMI correlated significantly with indices of left ventricular function.

Conclusions: Subclinical left ventricular diastolic dysfunction is present in all grades of isolated obesity, correlates with BMI, and is associated with increased systolic function in the early stages of obesity.

  • obesity
  • systolic function
  • diastolic function
  • echocardiography
  • A, maximum velocity of active mitral filling
  • AA, area under the curve of the velocity range corresponding to active mitral filling
  • AE, area under the curve of the velocity range corresponding to passive mitral filling
  • BMI, body mass index
  • E, maximum velocity of passive mitral filling
  • E/A, ratio of passive to active filling velocity
  • EDD, end diastolic diameter
  • EDV, end diastolic volume
  • EP, ejection period
  • ESD, end systolic diameter
  • ESV, end systolic volume
  • FS, fractional shortening
  • IVRT, isovolumic relaxation time
  • MV½T, mitral valve pressure half time
  • PEP, pre-ejection period
  • PWT, posterior wall thickness
  • RWT, relative wall thickness
  • VCS, velocity of circumferential fibre shortening

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