Background: Overweight is currently considered as the main risk factor for various chronic disorders, especially cardiovascular diseases. Unexpected hypertension is the first reaction of heart to overburden imposed by obesity or overweight. The purpose of the present study was to evaluate the correlation between body mass index (BMI) and echocardiographic findings in overweight patients compared with normal-weight population.
methods: This historical cohort study was conducted on 60 patients divided into two group of 30 based on their measured weights, group 1 with BMI of 20-25 kg/m2 as control and group 2 with 25<BMI≤30 kg/m2. All demographic and clinical data along with the echocardiographic findings were recorded for all samples.
Results: The mean age of control (41.06 ± 12.82 years) and oversights (46.84 ± 12.61 years) was not significantly different (P = 0.067). Systolic blood pressure (P = 0.003) and pulse rate (P = 0.028) were significantly higher in overweight group; ejection fraction (P = 0.036), end-systolic (P < 0.001) and end-diastolic (P < 0.001) left ventricular dimensions, and left ventricular mass index (P = 0.005) were significantly higher in control group.
Conclusion: Overweighting due to anatomical remodeling can cause diastolic heart failure in left ventricle. According to the relatively poor prognosis of treatment features in patients with probable risk factors of heart failure such as diabetes, hypertension and ischemic heart disease (IHD), it is recommended to consider overweight as an effective prognostic factor.
Kasper D. Harrison's Principles of Internal Medicine. 16th ed. New York, NY: McGraw Hill; 2005. p. 1463-81.
Reichek N, Devereux RB. Left ventricular hypertrophy: relationship of anatomic, echocardiographic and electrocardiographic findings. Circulation 1981; 63(6): 1391-8.
Shulman NB, Ford CE, Hall WD, Blaufox MD, Simon D, Langford HG, et al. Prognostic value of serum creatinine and effect of treatment of hypertension on renal function. Results from the hypertension detection and follow-up program. The Hypertension Detection and Follow-up Program Cooperative Group. Hypertension 1989; 13(5 Suppl): I80-I93.
Recommendations for routine blood pressure measurement by indirect cuff sphygmomanometry. American Society of Hypertension. Am J Hypertens 1992; 5(4 Pt 1): 207-9.
Schuster I, Vinet A, Karpoff L, Startun A, Jourdan N, Dauzat M, et al. Diastolic dysfunction and intraventricular dyssynchrony are restored by low intensity exercise training in obese men. Obesity (Silver Spring) 2012; 20(1): 134-40.
Kim H, Yoon HJ, Park HS, Cho YK, Nam CW, Hur SH, et al. Usefulness of tissue Doppler imaging-myocardial performance index in the evaluation of diastolic dysfunction and heart failure with preserved ejection fraction. Clin Cardiol 2011; 34(8): 494-9.
Lakhani M, Fein S. Effects of obesity and subsequent weight reduction on left ventricular function. Cardiol Rev 2011; 19(1): 1-4.
Kasner M, Westermann D, Steendijk P, Gaub R, Wilkenshoff U, Weitmann K, et al. Utility of Doppler echocardiography and tissue Doppler imaging in the estimation of diastolic function in heart failure with normal ejection fraction: a comparative Doppler-conductance catheterization study. Circulation 2007; 116(6): 637-47.
Tabata T, Oki T, Fukuda N, Iuchi A, Manabe K, Kageji Y, et al. Influence of left atrial pressure on left atrial appendage flow velocity patterns in patients in sinus rhythm. J Am Soc Echocardiogr 1996; 9(6): 857-64.
Aschenberg W, Schluter M, Kremer P, Schroder E, Siglow V, Bleifeld W. Transesophageal two-dimensional echocardiography for the detection of left atrial appendage thrombus. J Am Coll Cardiol 1986; 7(1): 163-6.
Pozzoli M, Febo O, Torbicki A, Tramarin R, Calsamiglia G, Cobelli F, et al. Left atrial appendage dysfunction: a cause of thrombosis? Evidence by transesophageal echocardiography-Doppler studies. J Am Soc Echocardiogr 1991; 4(5): 435-41.
Galinier M, Pathak A, Roncalli J, Massabuau P. Obesity and cardiac failure. Arch Mal Coeur Vaiss 2005; 98(1): 39-45. [In French].
Aljaroudi W, Alraies MC, Halley C, Rodriguez L, Grimm RA, Thomas JD, et al. Impact of progression of diastolic dysfunction on mortality in patients with normal ejection fraction. Circulation 2012; 125(6): 782-8.
Kazik A, Wilczek K, Polonski L. Management of diastolic heart failure. Cardiol J 2010; 17(6): 558-65.
Russo C, Jin Z, Homma S, Rundek T, Elkind MS, Sacco RL, et al. Effect of diabetes and hypertension on left ventricular diastolic function in a high-risk population without evidence of heart disease. Eur J Heart Fail 2010; 12(5): 454-61.
Langenberg C, Sharp SJ, Schulze MB, Rolandsson O, Overvad K, Forouhi NG, et al. Long-term risk of incident type 2 diabetes and measures of overall and regional obesity: the EPIC-InterAct case-cohort study. PLoS Med 2012; 9(6): e1001230.
Redfield MM, Jacobsen SJ, Burnett JC, Jr., Mahoney DW, Bailey KR, Rodeheffer RJ. Burden of systolic and diastolic ventricular dysfunction in the community: appreciating the scope of the heart failure epidemic. JAMA 2003; 289(2): 194-202.
Yu CM, Sanderson JE, Marwick TH, Oh JK. Tissue Doppler imaging a new prognosticator for cardiovascular diseases. J Am Coll Cardiol 2007; 49(19): 1903-14.
This work is licensed under a Creative Commons Attribution 4.0 International License.