Preclinical Systolic and Diastolic Dysfunctions in Metabolically Healthy and Unhealthy Obese Individuals
Journal
Circulation: Heart Failure
Journal Volume
8
Journal Issue
5
Pages
897-904
Date Issued
2015
Author(s)
Liang C.-S.
Gopal D.M.
Ayalon N.
Donohue C.
Santhanakrishnan R.
Sandhu H.
Perez A.J.
Downing J.
Gokce N.
Colucci W.S.
Ho J.E.
Abstract
Despite the substantial overlap of obesity and metabolic disease, there is heterogeneity with respect to cardiovascular risk. We sought to investigate preclinical differences in systolic and diastolic function in obesity, and specifically compare obese individuals with and without metabolic syndrome (MS). Methods and Results-Obese individuals without cardiac disease with (OB/MS+, n=124) and without (OB/MS-, n=37) MS were compared with nonobese controls (n=29). Diastolic function was assessed by transmitral and tissue Doppler. Global longitudinal strain (LS) and time-based dyssynchrony were assessed by speckle tracking. Both OB/MS-and OB/MS+ groups had similar ejection fraction but worse systolic mechanics as assessed by LS and dyssynchrony when compared with nonobese controls. Specifically, OB/MS-had 2.5% lower LS (SE, 0.7%; P=0.001 in multivariable-adjusted analyses) and 10.8 ms greater dyssynchrony (SE, 3.3 ms; P=0.002), and OB/MS+ had 1.0% lower LS (SE, 0.3%; P<0.001) and 7.8 ms greater dyssynchrony (SE, 1.5 ms; P<0.001) when compared with controls. Obesity was associated with impaired diastolic function regardless of MS status, as evidenced by greater left atrial diameter and left ventricular mass although diastolic dysfunction was more pronounced in OB/MS+ than in OB/MS-individuals. Conclusions-Obesity is associated with subclinical differences in both systolic and diastolic function regardless of the presence or absence of MS although MS seems to be associated with worse diastolic dysfunction. When compared with controls, metabolically healthy obese had lower LS, greater dyssynchrony, and early diastolic dysfunction, supporting the notion that obesity per se may have adverse cardiovascular effects regardless of metabolic disease. ? 2015 American Heart Association, Inc.
Subjects
Cardiovascular diseases; heart diseases; metabolic syndrome X; obesity; risk factors
SDGs
Other Subjects
cholesterol; creatinine; glucose; high density lipoprotein cholesterol; triacylglycerol; adult; Article; body mass; cardiovascular risk; cholesterol blood level; comparative study; controlled study; creatinine blood level; diastolic blood pressure; diastolic dysfunction; female; glucose blood level; heart left ventricle ejection fraction; heart left ventricle mass; human; major clinical study; male; metabolic syndrome X; obesity; priority journal; sex difference; systolic blood pressure; systolic dysfunction; tissue Doppler imaging; triacylglycerol blood level; waist circumference; complication; diastole; Doppler echocardiography; echography; etiology; heart left ventricle function; heart stroke volume; heart ventricle; metabolic syndrome X; obesity; pathophysiology; physiology; risk factor; systole; Adult; Diastole; Echocardiography, Doppler; Female; Heart Ventricles; Humans; Male; Metabolic Syndrome X; Obesity; Risk Factors; Stroke Volume; Systole; Ventricular Dysfunction, Left; Ventricular Function, Left
Publisher
Lippincott Williams and Wilkins
Type
journal article