Abstract
Obesity is a growing health problem worldwide. It is associated with an increased cardiovascular risk on the one hand of obesity itself and on the other hand of associated medical conditions (hypertension, diabetes, insulin resistance, and sleep apnoea syndrome). Obesity has an important role in atherosclerosis and coronary artery disease. Obesity leads to structural and functional changes of the heart, which causes heart failure. The altered myocardial structure increases the risk of atrial fibrillation and sudden cardiac death. However, obesity also has a protective effect on the clinical outcome of underlying cardiovascular disease, the phenomenon called obesity paradox. The improved cardiac imaging techniques allow the early detection of altered structure and function of the heart in obese patients. In this review, we attempt to summarize the relationship between obesity and cardiovascular diseases and outline the underlying mechanisms. The demonstrated new techniques of cardiac diagnostic procedures allow for the early detection and treatment of subclinical medical conditions and, therefore, the prevention of cardiovascular events.
Highlights
Obesity has been a health problem of growing significance all over the world; its prevalence is increasing in both developed and developing countries [1]
Body mass index (BMI) is used for measuring the extent of obesity; it gives no information on fat distribution, which is of high significance in cardiovascular risk [3]
Pulsatile wave tissue Doppler imaging (PW-TDI) measures the cardiac muscle movement velocity. These Doppler parameters are more precise and easier to reproduce than those obtained by means of 2D, M-mode echocardiography [109]. 3D imaging has lately been introduced in cardiology as well, which makes the determination of the ejection fraction (EF) and the volume of the left atrium and the left ventricle more precise [110]
Summary
Obesity has been a health problem of growing significance all over the world; its prevalence is increasing in both developed and developing countries [1]. Body mass index (BMI) is used for measuring the extent of obesity; it gives no information on fat distribution, which is of high significance in cardiovascular risk [3]. Novel clinical measurements (e.g., abdominal circumference and the calculation of waist/hip ratio) have been introduced with the aim of characterizing central or abdominal obesity. Abdominal circumference above 102 cm in the case of men and above 88 cm in the case of women qualifies as central obesity and involves increased cardiovascular risk [4]. A waist/hip ratio above 0.9 in the case of men and above 0.85 in the case of women indicates central obesity [5]
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