Obesity related changes in cardiac structure and function: role of blood pressure and metabolic abnormalities.

It has been reported that changes in cardiac structure and ventricular function associated with obesity have to be attributable to hemodynamic and non-hemodynamic alterations. Accordingly, the aim of this was to evaluate left ventricular hypertrophy (LVH) prevalence and its effect on left ventricular systolic and diastolic function in a cohort of obese patients. LV internal diameter (LVID), left ventricular mass (LVM) and LVM/height(LVMI), relative wall thickness (RWT), LV ejection fraction (LVEF), E/A ratio, isovolumic relaxation time, deceleration time of E velocity by echocardiography and pulsed-wave Doppler and total circulating adiponectin (ADPN) by radioimmunoassay were measured in 319 obese subjects with and without LVH. Increased values of BMI, WHR, SBP, DBP, MBP LVID, LVM, LVMI, IVST ( < .001), increased prevalence of subjects with LVEF< 50%,( < .001), central fat distribution ( < .001), hypertension ( < .001), diabetes ( < .001), metabolic syndrome ( < .02), and reduced value of ADPN ( < .0001) and LVEF ( < .001) were detected in LVH obese subjects than controls without LVH. No significant differences in diastolic parameters were observed between the two groups. LVEF correlated directly with ADPN ( < .0001) and inversely with age ( < .01), BMI ( < .01), WHR ( < .001), MBP ( < .01) MetS ( < .02) and LVMI ( < .001). WHR, MBP, LVMI and ADPN were independently associated with LVEF. In conclusion, our data indicate that obese subjects with LVH might be considered a distinct phenotype of obesity, characterised by LVH, increased prevalence of cardiometabolic comorbidities, central fat distribution, hypoadiponectinemia and early left ventricular systolic dysfunction.