Subclinical alterations in left ventricular structure and function according to obesity and metabolic health status

Lee, Hyun Jung; Kim, Hack‐Lyoung; Lim, Woo Hyun; Seo, Jae Bin; Kim, Sang Hyun; Zo, Joo Hee; Kim, Myung A.

doi:10.1371/journal.pone.0222118

Cited by 38 publications

(35 citation statements)

References 37 publications

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“…Previous studies showed that lean subjects with insulin resistance have an unfavorable inflammatory profile with elevated tumor necrosis factor-α and interleukin-6, while obese subjects exhibited a comparable inflammatory status regardless of insulin resistance [ 41 , 42 ]. In addition, obese individuals often have hypertension and sleep disorders such as sleep apnea, which can deteriorate LV function and may attenuate the association between insulin resistance and subclinical LV dysfunction [ 31 , 43 , 44 ]. Indeed, abnormal HOMA-IR was reported to be an independent predictor of cardiovascular mortality in normal weight individuals but not in overweight/obese individuals in the community-based cohort study [ 45 ].…”

Section: Discussionmentioning

confidence: 99%

Impact of insulin resistance on subclinical left ventricular dysfunction in normal weight and overweight/obese japanese subjects in a general community

Hirose

Nakanishi

Daimon

et al. 2021

Cardiovasc Diabetol

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Background Insulin resistance carries increased risk of heart failure, although the pathophysiological mechanisms remain unclear. LV global longitudinal strain (LVGLS) assessed by speckle-tracking echocardiography has emerged as an important tool to detect early LV systolic abnormalities. This study aimed to investigate the association between insulin resistance and subclinical left ventricular (LV) dysfunction in a sample of the general population without overt cardiac disease. Methods We investigated 539 participants who voluntarily underwent extensive cardiovascular health check including laboratory test and speckle-tracking echocardiography. Glycemic profiles were categorized into 3 groups according to homeostatic model assessment of insulin resistance (HOMA-IR): absence of insulin resistance (HOMA-IR < 1.5), presence of insulin resistance (HOMA-IR ≥ 1.5) and diabetes mellitus (DM). Multivariable logistic regression models were conducted to evaluate the association between abnormal glucose metabolism and impaired LVGLS (> − 16.65%). Results Forty-five (8.3%) participants had DM and 66 (12.2%) had abnormal HOMA-IR. LV mass index and E/e′ ratio did not differ between participants with and without abnormal HOMA-IR, whereas abnormal HOMA-IR group had significantly decreased LVGLS (− 17.6 ± 2.6% vs. − 19.7 ± 3.1%, p < 0.05). The prevalence of impaired LVGLS was higher in abnormal HOMA-IR group compared with normal HOMA-IR group (42.4% vs. 14.0%) and similar to that of DM (48.9%). In multivariable analyses, glycemic abnormalities were significantly associated with impaired LVGLS, independent of traditional cardiovascular risk factors and pertinent laboratory and echocardiographic parameters [adjusted odds ratio (OR) 2.38, p = 0.007 for abnormal HOMA-IR; adjusted OR 3.02, p = 0.003 for DM]. The independent association persisted even after adjustment for waist circumference as a marker of abdominal adiposity. Sub-group analyses stratified by body mass index showed significant association between abnormal HOMA-IR and impaired LVGLS in normal weight individuals (adjusted OR 4.59, p = 0.001), but not in overweight/obese individuals (adjusted OR 1.62, p = 0.300). Conclusions In the general population without overt cardiac disease, insulin resistance carries independent risk for subclinical LV dysfunction, especially in normal weight individuals.

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Section: Discussionmentioning

confidence: 99%

Impact of insulin resistance on subclinical left ventricular dysfunction in normal weight and overweight/obese japanese subjects in a general community

Hirose

Nakanishi

Daimon

et al. 2021

Cardiovasc Diabetol

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“…Patients with low GLS values demonstrated higher BMI (30.4 ± 5.7 vs. 26.4 ± 5.0, p = 0.005). Lee et al reported that obesity led to a decrease of GLS by 0.152% per 1 kg/m 2 change in BMI [42].…”

Section: Discussionmentioning

confidence: 99%

Global Longitudinal Strain at Rest as an Independent Predictor of Mortality in Liver Transplant Candidates: A Retrospective Clinical Study

Mechelinck

Hartmann

Hamada

et al. 2020

JCM

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Speckle tracking echocardiography enables the detection of subclinical left ventricular dysfunction at rest in many heart diseases and potentially in severe liver diseases. It could also possibly serve as a predictor for survival. In this study, 117 patients evaluated for liver transplantation in a single center between May 2010 and April 2016 with normal left ventricular ejection fraction were included according to clinical characteristics of their liver disease: (1) compensated (n = 29), (2) clinically significant portal hypertension (n = 49), and (3) decompensated (n = 39). Standard echocardiography and speckle tracking echocardiography were performed at rest and during dobutamine stress. Follow-up amounted to three years to evaluate survival and major cardiac events. Altogether 67% (78/117) of the patients were transplanted and 32% (31/96 patients) died during the three-year follow-up period. Global longitudinal strain (GLS) at rest was significantly increased (became more negative) with the severity of liver disease (p < 0.001), but reached comparable values in all groups during peak stress. Low (less negative) GLS values at rest (male: >−17/female: >−18%) could predict patient survival in a multivariate Cox regression analysis (p = 0.002). GLS proved valuable in identifying transplant candidates with latent systolic dysfunction.

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“…The relationship between EATV and LV strains remains to be elucidated. Previous studies indicated that an increase in the BMI ( 12 – 14 ) was correlated with reduced GLS. Further, the current study clarified that EATV was a determinant of LV GLS independent of BMI in patients with preserved LVEF.…”

Section: Discussionmentioning

confidence: 96%

“…Poor GLS could be a marker of early cardiac dysfunction in obese individuals. There were reports that body mass index (BMI) ( 12 – 14 ) or visceral fat area (VFA) ( 15 ) was negatively associated with GLS. It has been suggested that the accumulation of epicardial adipose tissue (EAT) underlies cardiac dysfunction in obesity ( 16 , 17 ).…”

Section: Introductionmentioning

confidence: 99%

Deleterious Effects of Epicardial Adipose Tissue Volume on Global Longitudinal Strain in Patients With Preserved Left Ventricular Ejection Fraction

Maimaituxun

Kusunose

Yamada

et al. 2021

Front. Cardiovasc. Med.

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Background: It is known that epicardial adipose tissue (EAT) volume is linked to cardiac dysfunction. However, it is unclear whether EAT volume (EATV) is closely linked to abnormal LV strain. We examined the relationship between EATV and global longitudinal strain (GLS), global circumferential strain (GCS), and global radial strain (GRS) in patients with preserved LV function.Methods: Notably, 180 consecutive subjects (68 ± 12 years; 53% men) underwent 320-slice multi-detector computed tomography coronary angiography and were segregated into coronary artery disease (CAD) (≥1 coronary artery branch stenosis ≥50%) and non-CAD groups. GLS, GCS, and GRS were evaluated by 2-dimensional speckle tracking in patients with preserved left ventricular (LV) ejection fraction (LVEF) ≥50%.Results: First, GLS, but not GRS and GCS, was lower in the high EATV group though the LVEF was comparable to the low EATV group. Frequency of GLS ≤18 was higher in the high EATV group. Second, multiple regression model showed that EATV, age, male sex, and CAD, were determinants of GLS. Third, the cutoff points of EATV were comparable (~116–117 mL) in both groups. The cutoff of EATV ≥116 showed a significant correlation with GLS ≤18 in overall subjects.Conclusions: Increasing EATV was independently associated with global longitudinal strain despite the preserved LVEF and lacking obstructive CAD. Our findings suggest an additional role of EAT on myocardial systolic function by impaired LV longitudinal strain.

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Subclinical alterations in left ventricular structure and function according to obesity and metabolic health status

Cited by 38 publications

References 37 publications

Impact of insulin resistance on subclinical left ventricular dysfunction in normal weight and overweight/obese japanese subjects in a general community

Impact of insulin resistance on subclinical left ventricular dysfunction in normal weight and overweight/obese japanese subjects in a general community

Global Longitudinal Strain at Rest as an Independent Predictor of Mortality in Liver Transplant Candidates: A Retrospective Clinical Study

Deleterious Effects of Epicardial Adipose Tissue Volume on Global Longitudinal Strain in Patients With Preserved Left Ventricular Ejection Fraction

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