Association of subclinical right ventricular dysfunction with obesity

Wong, C. .Y, O'Moore-Sullivan, T., Leano, R., Hukins, C., Jenkins, C. and Marwick, T. H. (2006) Association of subclinical right ventricular dysfunction with obesity. Journal of The American College of Cardiology, 47 3: 611-616.


Author Wong, C. .Y
O'Moore-Sullivan, T.
Leano, R.
Hukins, C.
Jenkins, C.
Marwick, T. H.
Title Association of subclinical right ventricular dysfunction with obesity
Journal name Journal of The American College of Cardiology   Check publisher's open access policy
ISSN 0735-1097
Publication date 2006
Sub-type Article (original research)
DOI 10.1016/j.jacc.2005.11.015
Volume 47
Issue 3
Start page 611
End page 616
Total pages 6
Editor A. N. DeMaria
Place of publication USA
Publisher Elsevier Inc
Collection year 2006
Language eng
Subject C1
321003 Cardiology (incl. Cardiovascular Diseases)
730106 Cardiovascular system and diseases
Abstract OBJECTIVES The purpose of this research was to identify the determinants of right ventricular (RV) dysfunction in overweight and obese subjects. BACKGROUND Right ventricular dysfunction in obese subjects is usually ascribed to comorbid diseases, especially obstructive sleep apnea. We used tissue Doppler imaging to identify the determinants of RV dysfunction in overweight and obese subjects. METHODS Standard and tissue Doppler echocardiography was performed in 112 overweight (body mass index [BMI] 25 to 29.9 kg/m(2)) or obese (BMI >30 kg/m(1)) subjects and 36 referents (BMI <25 kg/m(2)), including 22 with obstructive sleep apnea but no obesity. Tissue Doppler was used to measure RV systolic (s(m)) and diastolic (e(m)) velocities and strain indexes. 2 RESULTS Obese subjects with BMI >35 kg/m(2) had reduced RV function compared with referent subjects, evidenced by reduced s(m) (6.5 +/- 2.4 cm/s vs. 10.2 +/- 1.5 cm/s, p < 0.001), peak strain (-21 +/- 4% vs. -28 +/- 4%, p < 0.001), peak strain rate (-1.4 +/- 0.4 s(-1) vs. -2.0 +/- 0.5 s(-1), p < 0.001), and e(m) (6.8 +/- 2.4 cm/s vs. -10.3 +/- 2.5 cm/s, p < 0.001), irrespective of the presence of sleep apnea. Similar but lesser degrees of reduced systolic function (p < 0.05) were present in overweight (BMI 25 to 29.9 kg/m(2)) and mildly obese (BMI 30 to 35 kg/m(2)) groups. Differences in RV e(m), s(m), and strain indexes were demonstrated between the severely versus overweight and mildly obese groups (p < 0.05). Body mass index remained independently related to RV changes after adjusting for age, log insulin, and mean arterial pressures. In obese patients, these changes were associated with reduced exercise capacity but not the duration of obesity and presence of sleep apnea or its severity. CONCLUSIONS Increasing BMI is associated with increasing severity of RV dysfunction in overweight and obese subjects without overt heart disease, independent of sleep apnea.
Keyword Cardiac & Cardiovascular Systems
Obstructive Sleep-apnea
Insulin-resistance
Echocardiography
Strain
Mass
Validation
Metabolism
Pressure
Volume
Heart
Q-Index Code C1

 
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Created: Wed, 15 Aug 2007, 09:57:02 EST