Abstract
BackgroundObesity and metabolic syndrome (MetS) are associated with high risk of cardiac dysfunction and heart failure. We assessed the effect of obesity and metabolic health status on left ventricular (LV) structure and function in subjects without overt heart disease.MethodsIn 789 subjects (58.8±13.0 years, 50.7% males) without overt heart disease, LV morphology and function were compared among 6 groups stratified by body mass index (BMI) (normal weight, overweight and obese) and metabolic health status (meeting ≤1 criterion of MetS excluding waist circumference defined as metabolically healthy; otherwise, metabolically unhealthy).ResultsLV ejection fraction (LVEF) was not different among the 6 groups (P>0.05). However, high BMI and poor metabolic health were associated with poorer global longitudinal strain (GLS), higher LV mass index (LVMI) and higher E/e′ (P<0.001). Poor metabolic health status was associated with greater adverse changes in LV structure and function than obesity, and among MetS components, high systolic blood pressure (SBP) showed the greatest impact. Higher SBP, BMI and triglycerides were independently associated with worse GLS, and higher SBP was also associated with worse LVMI and E/e´. GLS, LVMI and E/e´ worsened in proportion to the number of MetS criteria or continuous MetS scores. Adverse myocardial changes associated with obesity were significant in the metabolically healthy group, but not in the metabolically unhealthy group.ConclusionsObesity and poor metabolic health status were associated with subclinical decrement in LV systolic and diastolic function, and higher LV mass, but not with LVEF, in subjects without overt heart disease.
Highlights
Obesity[1,2,3] and metabolic syndrome (MetS), as well as the individual components of MetS, [4,5,6] are associated with high risk of heart failure and cardiovascular diseases
High body mass index (BMI) and poor metabolic health were associated with poorer global longitudinal strain (GLS), higher left ventricular (LV) mass index (LVMI) and higher E/e0 (P
Higher systolic blood pressure (SBP), BMI and triglycerides were independently associated with worse GLS, and higher SBP was associated with worse LVMI and E/e
Summary
Obesity[1,2,3] and metabolic syndrome (MetS), as well as the individual components of MetS, [4,5,6] are associated with high risk of heart failure and cardiovascular diseases. Even in subjects without overt heart disease, obesity or MetS can cause adverse changes in cardiac structure and function, which may precede the development of heart failure. Obesity and metabolic syndrome (MetS) are associated with high risk of cardiac dysfunction and heart failure. We assessed the effect of obesity and metabolic health status on left ventricular (LV) structure and function in subjects without overt heart disease
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