Impact of Severe Obesity and Weight Loss on Systolic Left Ventricular Function and Morphology: Assessment by 2-Dimensional Speckle-Tracking Echocardiography

Karimian, Sevda; Stein, Jürgen M.; Bauer, Boris; Teupe, Claudius

doi:10.1155/2016/2732613

Cited by 14 publications

(9 citation statements)

References 37 publications

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“…VO 2 , fluid volume) and reduced LV workload. As discussed earlier, weight loss‐related loss of LVM has been studied in obese patients; however, these are of low small a magnitude compared with our observations (LVM −8.9%; LVM index −7.6%). The majority of patients were smokers, and it is likely that patients had subclinical coronary artery disease.…”

Section: Discussioncontrasting

confidence: 66%

“…In several studies in patients subjected to medical or nutritional interventions to induce weight loss, a decline in LVM was absent or much less pronounced than the fall in BMI. For example, in obese patients on a 12 week intervention (diet restriction to 800 kcal/day), a similar time frame to our study, patients lost 7.1 kg/m 2 (19% of body weight) without any detectable change in LVM . In two studies over 6 months post‐bariatric surgery, weight loss was very large (~ −13 kg/m 2 ); however, the loss of LVM per 1 unit loss of BMI was −0.53% and −0.61% .…”

Section: Discussionsupporting

confidence: 61%

“…Regarding cardiac structural changes in response to weight loss in non‐cancer individuals, several publications on weight reduction in obese persons suggest sparing of the cardiac mass [i.e. loss of weight is more pronounced than loss of LV mass (LVM)] . However, in cachexia, all muscles might atrophy simultaneously, if the tumour‐related catabolic drive generates signals acting on the different muscles and other tissues.…”

Section: Introductionmentioning

confidence: 99%

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Rapid atrophy of cardiac left ventricular mass in patients with non‐small cell carcinoma of the lung

Kazemi‐Bajestani

Becher²,

Butts

et al. 2019

J cachexia sarcopenia muscle

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BackgroundCancer is a systemic catabolic condition affecting skeletal muscle and fat. We aimed to determine whether cardiac atrophy occurs in this condition and assess its association with cardiac function, symptoms, and clinical outcomes.MethodsTreatment naïve metastatic non‐small cell lung cancer patients (n = 50) were assessed prior to and 4 months after commencement of carboplatin‐based palliative chemotherapy. Methods included echocardiography for left ventricular mass (LVM) and LV function [LV ejection fraction, global longitudinal strain (GLS), diastolic function], computed tomography to quantify skeletal muscle and total adipose tissue, Eastern Cooperative Oncology Group Performance Status (ECOG‐PS), validated questionnaires for dyspnoea and fatigue, plasma biomarkers, tumour response to therapy, and overall survival.ResultsDuring 112 ± 6 days, the median change in LVM was −8.9% [95% confidence interval (95% CI) −10.8 to −4.8, P < 0.001]. Quartiles of LVM loss were −20.1%, −12.9%, −4.8%, and +5.5%. Losses of muscle, adipose tissue, and LVM were frequently concurrent; LVM loss > median value was associated with loss of skeletal muscle [odds ratio (OR) = 4.5, 95% CI: 1.4–14.8, P=0.01] and loss of total adipose tissue (OR = 10.0, 95% CI: 2.7–36.7, P < 0.001). LVM loss was associated with decreased GLS (OR = 6.6, 95% CI: 1.9–22.7, P=0.003) but not with LV ejection fraction or diastolic function. In the population overall, plasma levels of C‐reactive protein (P=0.008), high sensitivity troponin T (hs‐TnT) (P=0.03), and galectin‐3 (P=0.02) increased over time, while N‐terminal pro B‐type natriuretic peptide and hs‐cTnI did not change over time. C‐reactive protein was the only biomarker associated with LVM loss but at the univariate level only. Independent predictors of LVM loss were prior weight loss (adjusted OR = 10.2, 95% CI: 2.2–46.9, P=0.003) and tumour progression (adjusted OR = 14.6, 95% CI: 1.4–153.9, P=0.02). LVM loss was associated with exacerbations of fatigue (OR = 6.6, 95% CI: 1.9–22.7, P=0.003), dyspnoea (OR = 9.3, 95% CI: 2.4–35.8, P<0.001), and deterioration of performance status (OR = 4.8, 95% CI: 1.3–18.3,P=0.02). Patients with concurrent loss of LVM, skeletal muscle, and fat were more likely to deteriorate in all three symptom domains and to have reduced survival (P=0.05).ConclusionsIntense LVM atrophy is associated with non‐small cell lung cancer‐induced cachexia. Loss of LVM was associated with emerging alterations of GLS, indicating subtle changes in left ventricular function. Longer term studies are needed to assess the full scope of cardiac atrophy and its impact. LVM atrophy arises in conjunction with losses of fat and skeletal muscle and is temporally associated with meaningful declines in performance status, worsening of fatigue, and dyspnoea, as well as poorer tumour response and decreased survival. The specific contribution of LVM atrophy to these outcomes requires further study.

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Section: Discussioncontrasting

confidence: 66%

Section: Discussionsupporting

confidence: 61%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Rapid atrophy of cardiac left ventricular mass in patients with non‐small cell carcinoma of the lung

Kazemi‐Bajestani

Becher²,

Butts

et al. 2019

J cachexia sarcopenia muscle

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“…All patients were participants in the OPTIFAST ® -52 diet program (Nestlé Health Science, Frankfurt, Germany). The study design has previously been described in detail 11. Briefly, the 52-week program included a fasting phase of 12 weeks with food ingestion restricted to formula products with a high protein content (total calorie intake approximately 800 kcal per day).…”

Section: Methodsmentioning

confidence: 99%

Improvement of impaired diastolic left ventricular function after diet-induced weight reduction in severe obesity

Karimian¹,

Stein²,

Bauer³

et al. 2017

DMSO

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Background/objectivesObesity is independently associated with left ventricular (LV) diastolic dysfunction and altered cardiac morphology. Morbidity and mortality in patients with diastolic dysfunction are similar to values observed in patients with systolic heart failure. We hypothesized that dysfunctional cardiac responses in people with obesity are reversible after weight loss. Thus, we studied the effect of dietary weight reduction on LV diastolic function as well as on cardiac structure using transthoracic echocardiography and tissue Doppler imaging (TDI).Subjects/methodsThirty-two subjects with obesity underwent a 12-week low-calorie fasting phase of a formula diet. Echocardiographic tissue Doppler indices of diastolic function and measurements of cardiac size were obtained prior to and after the fasting phase.ResultsA 12-week diet significantly reduced body mass index from 40.3 ± 6.6 kg/m2 to 33.2 ± 6.1 kg/m2 (p < 0.01). Weight loss was associated with a significant reduction in blood pressure and heart rate. Echocardiography revealed diastolic dysfunction in subjects with obesity, which was improved by dieting. After weight loss, trans-mitral Doppler echocardiography showed a significant reduction in A-wave velocity, from 65.8 ± 19.2 cm/s to 57.0 ± 16.8 cm/s, and an increase in E/A ratio from 1.2 ± 0.4 to 1.4 ± 0.5 (p < 0.01). TDI displayed a significantly lower a′-wave velocity (10.3 ± 2.3 cm/s and 8.9 ± 1.7 cm/s; p < 0.01). Left atrial and LV dimensions were normal and remained unchanged after weight loss.ConclusionObesity is associated with diastolic dysfunction. A 12-week low-calorie diet with successful weight loss can reduce blood pressure and heart rate and partially normalize diastolic dysfunction.

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“…Obesity elevates not only the levels of blood lipid and blood glucose but also the buildup of fatty tissue which enhances vascular resistance and leads to a high risk of hypertension. Long‐term heightened vascular resistance and hypertension raises the likelihood of ventricular hypertrophy, or enlargement of the heart . In addition, the increased low‐density lipoprotein cholesterol and decreased high‐density lipoprotein (HDL) cholesterol levels resulting from obesity contribute to a high risk of atherosclerosis…”

Section: Nanotechnology As a Treatment For Obesity‐related Comorbiditiesmentioning

confidence: 99%

Nanotechnology‐Mediated Drug Delivery for the Treatment of Obesity and Its Related Comorbidities

Tsou

Wang

et al. 2019

Adv Healthcare Materials

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Obesity is a serious health issue affecting humanity on a global scale. Recognized by the American Medical Association as a chronic disease, the incidence of obesity continues to grow at an accelerating rate and obesity has become one of the major threats to human health. Excessive weight gain is tied to metabolic syndrome, which is shown to increase the risk of chronic diseases, such as heart disease and type 2 diabetes, taxing an already overburdened healthcare system and increasing mortality worldwide. Available treatments such as bariatric surgery and pharmacotherapy are often accompanied by adverse side effects and poor patient compliance. Nanotechnology, an emerging technology with a wide range of biomedical applications, has provided an unprecedented opportunity to improve the treatment of many diseases, including obesity. This review provides an introduction to obesity and obesity‐related comorbidities. The most recent developments of nanotechnology‐based drug delivery strategies are highlighted and discussed. Additionally, challenges and consideration for the development of nanoformulations with translational potential are discussed. The overall objective of this review is to enhance the understanding of the design and development of nanomedicine for treatments of obesity and related comorbidities.

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Impact of Severe Obesity and Weight Loss on Systolic Left Ventricular Function and Morphology: Assessment by 2-Dimensional Speckle-Tracking Echocardiography

Cited by 14 publications

References 37 publications

Rapid atrophy of cardiac left ventricular mass in patients with non‐small cell carcinoma of the lung

Rapid atrophy of cardiac left ventricular mass in patients with non‐small cell carcinoma of the lung

Improvement of impaired diastolic left ventricular function after diet-induced weight reduction in severe obesity

Nanotechnology‐Mediated Drug Delivery for the Treatment of Obesity and Its Related Comorbidities

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