Cardiac remodeling and subclinical left ventricular dysfunction in adults with uncomplicated obesity: a cardiovascular magnetic resonance study

Abstract

Background: Obesity often exists alongside comorbidities and increases the risk of heart failure and cardiovascular mortality. However, the specific effects of obesity on cardiac structure and function have not been clarified. This study set out to evaluate left ventricular (LV) geometric and functional changes using cardiovascular magnetic resonance imaging (CMR) in adults with uncomplicated obesity.Methods: Forty-eight patients with uncomplicated obesity [body mass index (BMI) mean ± SD: 29.8±2.1 kg/m 2 ] and 25 healthy controls were included in this study. CMR was used to assess LV geometry, global systolic function, and strains, and to quantify epicardial adipose tissue (EAT). Body composition was measured by dual X-ray absorptiometry.Results: Compared with healthy controls, patients with obesity had increased LV size, mass, and myocardial thickness, and impaired myocardial contractility, with lower global radial, circumferential, and longitudinal peak strains (PS), and circumferential and longitudinal peak diastolic strain rates (PDSR; all P<0.05). Multivariable linear regression showed that BMI was independently associated with LV maximum myocardial thickness (LVMMT) (β=0.197, P=0.016). Visceral adipose tissue (VAT) was independently associated with LV global longitudinal PS (β=-2.684, P=0.001), and both longitudinal (β=-0.192, P=0.002) and circumferential (β=-0.165, P=0.014) PDSR. Homeostasis model assessment of insulin resistance (HOMA-IR) was mildly correlated with BMI (r=0.327) and body fat percentage (BF%) (r=0.295) in patients with obesity (all P<0.05). HOMA-IR was independently associated with LV global circumferential PS (β=-0.276, P=0.04) and PDSR (β=-0.036, P=0.026).Conclusions: Extensive LV geometric remodeling and marked changes in cardiac strains were observed in adults with obesity. Tissue tracking with CMR can reveal subclinical impaired ventricular function with preserved LV ejection fraction in such patients. BMI was independently related to LV remodeling in obesity. HOMA-IR and VAT are potentially superior to BMI as predictors of subclinical dysfunction, assessed by strain, in obesity.

The correlation of pericoronary adipose tissue with coronary artery disease and left ventricular function

“…Some studies on the correlation between epicardial fat volume (EFV) and CAD reported that the increase of EFV was positively correlated with the risk of CAD [ 16 , 17 ]. Severe CAD often leads to changes in cardiac function, and studies have shown that there is a correlation between EVF and LV function parameters [ 18 , 19 ]. Thus, we analyzed the relationship between PCAT volume, Gensini score, and LV function parameters and found that there was no correlation between them.…”

Impact of surgical and non-surgical weight loss on echocardiographic and strain parameters in Asian patients

“…A CMR study conducted by Liu et al demonstrated increased LV size, thickness, and impaired myocardial contractility in Asian patients with uncomplicated obesity with a similar BMI pro le of 28 kg/m 2 . (31) These ndings suggest adverse remodeling starts to occur at lower levels of BMI than previously thought.…”

The Correlation of Pericoronary Adipose Tissue with Coronary artery disease and left ventricular function

“…We analyzed the relationship between PCAT and CAD, and found that there was no correlation between PCAT volume and Gensini score and cardiac function parameters. However, some studies on the correlation between epicardial fat volume (EFV) and CAD and cardiac function show that the increase of EFV was positively correlated with the risk of CAD and left ventricular function parameters [15][16][17][18] . The possible reason is that the measurement methods are different.…”