Prevalence Of Diastolic Dysfunction And Association With Peak Vo2 In Obese Patients Without History Of Heart Disease

Abstract

PURPOSE: Diastolic dysfunction (DD) can cause increased pressure und fluid in the blood vessel of the lung which might lead to dyspnea on exertion. Moreover, dyspnea is a common symptom in obese patients. Thus, we sought to evaluate the prevalence of DD in obese patients and to assess whether obese patients with DD have a reduced peak VO2. METHODS: 92 consecutive obese patients (22 female, mean age 42 ±11.7 years [18-70], mean BMI 44.3 ± 8.6 kg/m2 [30.0-74.7]) with normal systolic left ventricular function were included in this study. All patients were evaluated by echocardiography prior to incremental treadmill exercise testing using a walking protocol to determine peak VO2. Diastolic dysfunction was defined as an inversed E/A-ratio derived from transmitral valve flow pattern. RESULTS: DD was observed in 35/92 patients (38%). Mean peak VO2 was 20.2 ± 4.6 mL/kg/min [10-31] with a significant high value in patients with normal diastolic function (21.0 ± 4.8 mL/kg vs. 18.9 ± 4.1 mL/kg, p<0.05). However, after adjustment for age, gender and body mass index, this difference was no longer significant. CONCLUSIONS: Diastolic dysfunction is common in obese patients without history of prior heart disease. However, in a multifactorial model the presence of diastolic dysfunction was not associated with reduced peak VO2 as assessed by treadmill test. Thus, dyspnea in obese patients with diastolic dysfunction might not be explained by a reduced peak VO2.