Early cardiac risk stratification in obese patients: the need of new simple diagnostic tools

Abstract

In the last few years, increasing evidence about the role played by obesity as cardiovascular risk factor has been shown. However, not all the obese patients are at the same high cardiovascular risk and it is important to have simple and reliable diagnostic tools to detect those patients worthy of a stricter cardiovascular prevention. The purpose of the present pilot study was to test the capability of biomarker dosage in detecting early cardiac dysfunction. Twenty-eight consecutive obese patients, visited at the obese clinic of the San Maurizio Regional Hospital of Bolzano were included in the study. The patients with known cardiovascular disease were excluded. All the patients underwent the dosage of copeptin, mid regional proANP (Mr-proANP), BNP, the standard haematological testing and a complete echocardiography. All the patients had a normal ejection fraction of the left ventricle (61 ± 5.2 %), normal copeptin (median 8.2 pmol/L with and interquartile range of 6.05–12.6) and BNP levels (37.0 ± 27.5 pg/mL). Mr-proANP was 67.5 ± 45.5 pmol/L, resulting above the upper level of normality in 5/28 patients (17.8 %). No significant relation was found between copeptin levels and left ventricular volumes, mass, ejection fraction, atrial dimensions and diastolic function. Mr-proANP showed a significant reverse non-linear relationship with diastolic dysfunction of the left ventricle, measured by E/E′ ratio. BPN, on the contrary, showed a significant non-linear relation with diastolic dysfunction. BNP dosage has been shown to have efficacy in early identification of heart dysfunction, even in the presence of preserved systolic function.