E ect of overweight and obesity on the le ventricular systolic and diastolic functions in patients with acute myocardial infarction

Purpose: e purpose of this study was to evaluate whether a association exits among overweight and obesity and le ventricular systolic and diastolic functions in patients admitted with rst ST-elevation myocardial infarction (STEMI). Methods: e present study was performed on 451 consecutive patients diagnosed with rst STEMI (376 men, 75 women; mean age 56.1±10.8 years). e patients were classi ed into three groups based on their body mass index (BMI) as normal weight (BMI < 25 kg/ m2), overweight (BMI: 25-29.9 kg/m2) and obese (BMI>30 kg/m2). Echocardiographic features were evaluated and compared among the three groups. Results: Mitral annulus E velocities were higher in obese individuals than normal weight group (p <0.01). In contrast, mitral A velocities were lower (p =0.03); consequently, E\A and E'\A' ratios were lower (both p =0.01) in the obese group with respect to normal weight group. When the correction of entire variations existing among the groups were performed using multivariate linear regressions analyses, it turned out that BMI was independently associated with E/A (β= -0.19, p =0.044) and with E'/A' (β= -0.016, p=0.021). Ejection fraction, wall motion score index and myocardial S velocities were comparable among the study groups (p >0.05). Conclusion: ese results suggest that while obesity has no adverse e ect on the le ventricular systolic function, it has unfavorable consequences on the le ventricular diastolic function in the patients with rst STEMI. In contrast, no unfavorable e ects of overweight on the le ventricular systolic and diastolic function were detected. ORIGINAL RESEARCH © 2012 CIM Clin Invest Med • Vol 35, no 4, August 2012 E229 Correspondence to: Fatih Poyraz, MD Atatürk Mah, Adnan İnanıcı Cad, Sokak No 1108, Bulvar Konutları, 1 Blok, No 2, Şehitkamil/Gaziantep (Turkey) E-mail: [email protected] Manuscript submitted 14th April, 2012 Manuscript accepted 6th June, 2012 Clin Invest Med 2012; 35 (4): E229-E236. Overweight and obesity are growing public health problems worldwide [1,2]. ey have been shown to be associated with increased risk of developing coronary artery diseases (CAD) with resultant elevated morbidity and mortality [3-5]. e American Heart Association describes obesity as an independent cardiovascular risk factor [6]. Moreover, several studies show a relationship between increased body mass and the development of heart failure [7,8]. Adverse e ects of overweight and obesity on the le ventricular systolic and diastolic functions are shown in prede ned populations [9-12]. e severity of the deterioration in the le ventricular systolic and diastolic functions a er acute myocardial infarction (AMI) has been revealed to be strongly associated with a poor prognosis [13]. Nonetheless, the numbers of the studies examining the impact of overweight and obesity on the le ventricular functions a er AMI are limited. erefore, the e ect of overweight and obesity on the le ventricular systolic and diastolic functions in the patients admitted with rst STEMI have been evaluated. Materials and Methods