Effects of Isolated Obesity on Left and Right Ventricular Function: A Tissue Doppler and Strain Rate Imaging Study

Orhan, Ahmet Lütfüllah; Uslu, Nevzat; Dayı, Şennur Ünal; Nurkalem, Zekeriya; Uzun, Fatih; Erer, Hatice Betül; Hasdemir, Hakan; Emre, Ayşe; Karakuş, Gültekin; Soran, Özlem; Gorcsan, John; Eren, Mehmet

doi:10.1111/j.1540-8175.2009.01024.x

Cited by 85 publications

(80 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In contrast to the above mentioned results, we and others 17,25,26) have found no association of RV function and increasing BMI in obese and/or overweight persons. Additionally, right atrial and right ventricular end-systolic and diastolic dimensions, as well as RV diastolic function did not differ significantly across increasing BMI categories.…”

Section: Discussioncontrasting

confidence: 43%

“…Additionally, right atrial and right ventricular end-systolic and diastolic dimensions, as well as RV diastolic function did not differ significantly across increasing BMI categories. 17,25,26) On the other hand, these studies consistently found significant alterations of LV parameters, implying more sensible adaptions of the left than the right heart to increasing adiposity. The reasons for the incongruent study results remain speculative.…”

Section: Discussionmentioning

confidence: 85%

“…Notably, in the above mentioned study by Orhan, et al, duration of obesity was particularly associated with impaired RV function. 17) In this small study, TDI S' was slightly lower in the obese compared to controls. However, mean TDI S' was within the normal range and RV TAPSE levels were similar in obese and non-obese subjects.…”

Section: Discussionmentioning

confidence: 96%

“…17) In this study, significant impairment of both LV and RV systolic function in obese subjects was detected using strain rate imaging, although several conventional and TDI echocardiographic systolic parameters did not show any statistically significant differences between the obese and non-obese groups. This has been explained by the relative insensitivity of conventional and TDI-derived echocardiographic methods that may not be able to detect early abnormalities in longitudinal function, in contrast to strain rate imaging methods.…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Relation Between Obesity, Metabolic Syndrome, Successful Long-Term Weight Reduction, and Right Ventricular Function

et al. 2016

View full text Add to dashboard Cite

SummaryThis study sought to examine the relationships between right ventricular (RV) function and geometry, morbid obesity with and without the metabolic syndrome, and the effect of long-term weight loss. Obese (n = 153, BMI 41.2 ± 8.7 kg/m 2 ) and healthy non-obese control subjects (n = 38, BMI 25.5 ± 3.3 kg/m 2 ) of similar age and gender distribution were prospectively studied during the course of a 1-year weight reduction program with echocardiography at baseline and after one year of follow up. Function and geometry of the right heart were evaluated by tricuspid annular plane systolic excursion (TAPSE), tricuspid annular systolic velocity (TDI S'), RV myocardial performance index (TEI), RV end-diastolic (RVEDD) and end-systolic diameter (RVESD), area of the right atrium (RAA), and systolic pulmonary artery pressure (PAP). Whereas parameters of systolic and diastolic LV function were significantly worse in the obese subjects than those in the non-obese subjects (EF 66 ± 6 versus 69 ± 6%, P = 0.004; E/E' 7.4 ± 2.5 versus 6.3 ± 2.6, P = 0.010), parameters of RV function (TAPSE 25.6 ± 4.5 versus 25.1 ± 3.5 mm, P = 0.528; TDI S' 13.5 ± 2.9 versus 13.8 ± 2.9 mm/second, P = 0.553; TEI 0.25 ± 0.13 versus 0.28 ± 0.09, P = 0.283) as well as geometry measurements were comparable between the obese and non-obese participants and also in obese subjects with full blown metabolic syndrome. Additionally, successful weight reduction did not alter the RV parameters. Nevertheless, in the few obese subjects with RV dysfunction (n = 7), metabolic syndrome parameters were more pronounced than in obese with normal RV function.Morbid obesity with and without the metabolic syndrome is accompanied by an impaired LV systolic and diastolic function. In contrast, RV function appears to be less affected by obesity independent of the presence of the metabolic syndrome. (Int Heart J 2016; 57: 441-448) Key words: Adiposity, Heart failure, Echocardiography O besity and the metabolic syndrome are fast-growing disorders in western countries which are associated with variant cardiovascular abnormalities leading to a high risk of cardiovascular morbidity and mortality.1) The Framingham Heart Study demonstrated a 2-fold higher risk of developing heart failure in obese subjects with a body mass index ≥ 30 kg/m 2 in comparison to non-obese ones in a large community-based sample.2) Moreover, adiposity was described as an independent risk factor for developing heart failure with a population attributable risk of 8.0% in a large prospective cohort study with a follow-up of 19 years. 3)Adiposity results in different subclinical changes in cardiac function.1) Arterial hypertension, impaired glucose tolerance, dyslipidemia, altered hemodynamics, elevation of neurohumoral and inflammatory markers, prothrombotic state, and obstructive sleep apnea are associated conditions which may further predispose to heart failure. [2][3][4] While the influence of obesity on left ventricular (LV) function is understood in more detail, such as the correlation of body ...

show abstract

Section: Discussioncontrasting

confidence: 43%

Section: Discussionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Relation Between Obesity, Metabolic Syndrome, Successful Long-Term Weight Reduction, and Right Ventricular Function

et al. 2016

View full text Add to dashboard Cite

show abstract

“…Previous studies suggested that some factors such as obesity, insulin resistance and age could affect the myocardial strain measurements. Obesity can cause a subclinical impairment in myocardial functions alone (14,15). Insulin resistant people can show subclinic deterioration in myocardial functions (16).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Polycystic Ovary Syndrome Patients with Strain Echocardiography

Aslan¹,

Aslan²,

Sade³

et al. 2015

IJWHR

View full text Add to dashboard Cite

IntroductionPolycystic Ovary Syndrome (PCOS) is a disorder of the reproductive system and is seen in 5 to 10% of the women in reproductive ages (1). Its main features are hyperandrogenism both clinical or biochemical and/or chronic oligo-anovulation and/or ultrasonographic appearance of the polycystic ovaries (2). There are many studies showing the relationship between PCOS and Cardiovascular Diseases (CVD). Insulin resistance, obesity, hypertension, hyperlipidemia, hypercoagulability, and endothelial dysfunction can be seen frequently in PCOS patients along with increased cardiovascular risks (3). Previously published data show that coronary atherosclerosis and increased carotid intima-media thickness can be observed in PCOS (4). The aim of our study was to determine the effects of metabolic factors on myocardial functions in PCOS patients, by measuring the strain (S) and strain rate (SR) as means of quantification of myocardial functions, which were first described by Heimdal et al. to define the global and regional myocardial dysfunction (5), and to identify the possible subclinical impairment of left ventricular myocardial function because of the metabolic components of PCOS. Materials and Methods Study populationThis study was carried out with 26 PCOS patients referred to the Obstetrics and Gynecology Clinic of Baskent University Hospital between December 2008 and September 2009 and 23 healthy female volunteers as control group. The PCOS patients were diagnosed in accordance with 2003 Rotterdam criteria (2). There were neither menstrual cycle abnormalities nor hyperandrogenism in the control group both clinically and biochemically. Clinical symptoms of hyperandrogenism were acne and/or hirsutism. A score higher than 7 based on the modified Ferriman-Gallwey Scale was noted as hirsutism. Any disease other than PCOS including hypertension, diabetes, thyroid function abnormalities, Cushing syndrome, asthma, and other auto-immune diseases, and all medical conditions which caused regular drug use were exclusion criteria for our study. All participants signed the informed consent before enrolling in our study. A physical examination with a detailed anamnesis including body weight and height were performed in all participants. Body Mass Index (BMI) was determined as body weight (kilograms) divided by height (meters) squared. AbstractObjectives: Polycystic Ovary Syndrome (PCOS) is characterized by several metabolic abnormalities that may lead to insulin resistance, diabetes, and atherosclerosis which are associated with chronic inflammatory processes and oxidative stress. Due to this fact PCOS patients are at increased risk of cardiovascular diseases. We used echocardiographic quantification tools to detect subclinical changes in myocardial functions. Materials and Methods:Echocardiographic, hormonal and metabolic measurements were performed in twenty-six women with PCOS and twenty-three healthy volunteers. The age of the attendants ranged between 20 and 31 years. PCOS was diagnosed by using the Rotterdam criteria. ...

show abstract

Strain Imaging in Morbid Obesity: Insights Into Subclinical Ventricular Dysfunction

Barbosa

Diniz

et al. 2011

Clinical Cardiology

View full text Add to dashboard Cite

Background: Obesity has become an important health problem throughout the world. Early detection of cardiovascular abnormalities may be useful in the future for patient management. This study aimed to identify subclinical ventricular dysfunction in obese patients. Hypothesis: Morbid obesity is associated with ventricular dysfunction. Methods: Doppler echocardiogram was performed in 92 morbidly obese and in 31 healthy controls. Conventional echocardiography and tissue Doppler-based strain imaging were used to analyze ventricular function. Intra-and interobserver strain imaging variabilities were tested on 15 randomly selected cases. Results: Left ventricular (LV) global strain (22.5% ± 3.5 vs 24.4% ± 2.5, P < 0.005) and right ventricular (RV) strain (25.8% ± 5.2 vs 28.2% ± 5.2, P < 0.029) were lower in obese patients when compared with healthy controls. Echocardiographic parameters of diastolic function were also different from controls. LV strain correlated with LV mass, E/e ratio, left atrial volume, and RV strain. At multivariate analysis, morbid obesity remained a significant determinant of global LV strain, independently of associated comorbidities. Conclusions: These findings suggest that incipient biventricular dysfunction is present in morbidly obese patients when new echocardiographic indices are used to investigate ventricular function. In addition, strain imaging may provide a more accurate assessment of the ventricular function in obese patients.

show abstract

Effects of Isolated Obesity on Left and Right Ventricular Function: A Tissue Doppler and Strain Rate Imaging Study

Cited by 85 publications

References 40 publications

Relation Between Obesity, Metabolic Syndrome, Successful Long-Term Weight Reduction, and Right Ventricular Function

Relation Between Obesity, Metabolic Syndrome, Successful Long-Term Weight Reduction, and Right Ventricular Function

Evaluation of Polycystic Ovary Syndrome Patients with Strain Echocardiography

Strain Imaging in Morbid Obesity: Insights Into Subclinical Ventricular Dysfunction

Contact Info

Product

Resources

About