lterations in Left Ventricular Structure nd Function in Young Healthy Obese Women

OBJECTIVES This study was designed to determine the effects of obesity on left ventricular (LV) structure and function in young obese women. BACKGROUND Severe prolonged obesity in older adults results in increased plasma volume, eccentric LV hypertrophy, and systolic and diastolic dysfunction. Obese women are at increased risk for the development of heart failure. However, the effects of the obesity on cardiac structure and function in young, otherwise-healthy women are controversial. METHODS Fifty-one women were evaluated: 20 were obese (body mass index [BMI] 30 kg/m) and 31 were non-obese (BMI 30 kg/m). Left ventricular structure and systolic and diastolic function were assessed by two-dimensional echocardiography and tissue Doppler imaging, including the load-independent systolic myocardial velocity (Sm global) and early diastolic myocardial velocity (Em global), respectively. The effects of BMI on LV structure and function were assessed using multivariate regression analyses. RESULTS Obese women had higher end-diastolic septal and posterior wall thickness, LV mass, and relative wall thickness than non-obese women; BMI values showed significant correlations with these variables (r 0.58, p 0.0001; r 0.50, p 0.0002; r 0.52, p 0.0001, and r 0.40, p 0.005, respectively). The Sm global and Em global were lower in obese women, suggesting systolic and diastolic function are decreased; both were negatively correlated with BMI (r 0.43, p . 002 and r 0.61, p 0.0001, respectively). Multivariate analysis showed BMI was the only independent predictor of relative wall thickness, Sm global, and Em global. CONCLUSIONS Obesity in young otherwise-healthy women is associated with concentric LV remodeling and decreased systolic and diastolic function. These early abnormalities in LV structure and function may have important implications for explaining the myocardial dysfunction that is associated with increased cardiovascular morbidity and mortality caused by obesity. (J Am Coll Cardiol 2004;43:1399–404) © 2004 by the American College of Cardiology Foundation