Effect of obesity and overweight on left ventricular diastolic function: A community-based study in an elderly cohort

Cesare Russo, Zhezhen Jin, Shunichi Homma, Tatjana Rundek, Mitchell S V Elkind, Ralph L Sacco, Marco R. Di Tullio

Research output: Contribution to journalArticle

178 Citations (Scopus)

Abstract

Objectives: The purpose of this study was to assess the independent effect of increased body size on left ventricular (LV) diastolic function. Background: Obese and overweight persons are at increased risk of heart failure. Left ventricular diastolic dysfunction is an asymptomatic condition associated with future heart failure. It is unclear whether obesity and overweight are independently associated with LV diastolic dysfunction. Methods: The LV diastolic function was evaluated in 950 participants from the CABL (Cardiovascular Abnormalities and Brain Lesions) study by traditional and tissue Doppler imaging. Peak early transmitral diastolic flow velocity (E), late transmitral diastolic flow velocity (A), and early diastolic mitral annulus velocity (E′) were measured, and E/A and E/E′ were calculated. The study sample was divided into 3 groups: normal weight (body mass index [BMI] <25.0 kg/m 2), overweight (BMI 25.0 to 29.9 kg/m 2), and obese (BMI ≥30 kg/m 2). Results: In multivariate analyses, BMI was independently associated with higher E, A, and E/E′, an indicator of LV filling pressure (all p ≤ 0.01). Overweight and obese had lower E′ (both p < 0.01) and higher E/E′ (both p < 0.01) than normal weight participants. The E/A was lower in obese subjects than in normal weight subjects (p < 0.01). The risk of diastolic dysfunction was significantly higher in overweight subjects (adjusted odds ratio: 1.52, 95% confidence interval: 1.04 to 2.22) and obese subjects (adjusted odds ratio: 1.60, 95% confidence interval: 1.06 to 2.41) compared to normal weight subjects. Conclusions: Increased BMI was associated with worse LV diastolic function independent of LV mass and associated risk factors. The increased risk of LV diastolic dysfunction in both overweight and obese persons may partially account for the increased risk of heart failure associated with both conditions.

Original languageEnglish
Pages (from-to)1368-1374
Number of pages7
JournalJournal of the American College of Cardiology
Volume57
Issue number12
DOIs
StatePublished - Mar 22 2011

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Left Ventricular Function
Obesity
Body Mass Index
Left Ventricular Dysfunction
Weights and Measures
Heart Failure
Odds Ratio
Confidence Intervals
Cardiovascular Abnormalities
Asymptomatic Diseases
Body Size
Ventricular Pressure
Multivariate Analysis
Brain

Keywords

  • diastolic dysfunction
  • echocardiography
  • obesity
  • overweight
  • risk factors

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Effect of obesity and overweight on left ventricular diastolic function : A community-based study in an elderly cohort. / Russo, Cesare; Jin, Zhezhen; Homma, Shunichi; Rundek, Tatjana; Elkind, Mitchell S V; Sacco, Ralph L; Di Tullio, Marco R.

In: Journal of the American College of Cardiology, Vol. 57, No. 12, 22.03.2011, p. 1368-1374.

Research output: Contribution to journalArticle

Russo, Cesare ; Jin, Zhezhen ; Homma, Shunichi ; Rundek, Tatjana ; Elkind, Mitchell S V ; Sacco, Ralph L ; Di Tullio, Marco R. / Effect of obesity and overweight on left ventricular diastolic function : A community-based study in an elderly cohort. In: Journal of the American College of Cardiology. 2011 ; Vol. 57, No. 12. pp. 1368-1374.
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abstract = "Objectives: The purpose of this study was to assess the independent effect of increased body size on left ventricular (LV) diastolic function. Background: Obese and overweight persons are at increased risk of heart failure. Left ventricular diastolic dysfunction is an asymptomatic condition associated with future heart failure. It is unclear whether obesity and overweight are independently associated with LV diastolic dysfunction. Methods: The LV diastolic function was evaluated in 950 participants from the CABL (Cardiovascular Abnormalities and Brain Lesions) study by traditional and tissue Doppler imaging. Peak early transmitral diastolic flow velocity (E), late transmitral diastolic flow velocity (A), and early diastolic mitral annulus velocity (E′) were measured, and E/A and E/E′ were calculated. The study sample was divided into 3 groups: normal weight (body mass index [BMI] <25.0 kg/m 2), overweight (BMI 25.0 to 29.9 kg/m 2), and obese (BMI ≥30 kg/m 2). Results: In multivariate analyses, BMI was independently associated with higher E, A, and E/E′, an indicator of LV filling pressure (all p ≤ 0.01). Overweight and obese had lower E′ (both p < 0.01) and higher E/E′ (both p < 0.01) than normal weight participants. The E/A was lower in obese subjects than in normal weight subjects (p < 0.01). The risk of diastolic dysfunction was significantly higher in overweight subjects (adjusted odds ratio: 1.52, 95{\%} confidence interval: 1.04 to 2.22) and obese subjects (adjusted odds ratio: 1.60, 95{\%} confidence interval: 1.06 to 2.41) compared to normal weight subjects. Conclusions: Increased BMI was associated with worse LV diastolic function independent of LV mass and associated risk factors. The increased risk of LV diastolic dysfunction in both overweight and obese persons may partially account for the increased risk of heart failure associated with both conditions.",
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T1 - Effect of obesity and overweight on left ventricular diastolic function

T2 - A community-based study in an elderly cohort

AU - Russo, Cesare

AU - Jin, Zhezhen

AU - Homma, Shunichi

AU - Rundek, Tatjana

AU - Elkind, Mitchell S V

AU - Sacco, Ralph L

AU - Di Tullio, Marco R.

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AB - Objectives: The purpose of this study was to assess the independent effect of increased body size on left ventricular (LV) diastolic function. Background: Obese and overweight persons are at increased risk of heart failure. Left ventricular diastolic dysfunction is an asymptomatic condition associated with future heart failure. It is unclear whether obesity and overweight are independently associated with LV diastolic dysfunction. Methods: The LV diastolic function was evaluated in 950 participants from the CABL (Cardiovascular Abnormalities and Brain Lesions) study by traditional and tissue Doppler imaging. Peak early transmitral diastolic flow velocity (E), late transmitral diastolic flow velocity (A), and early diastolic mitral annulus velocity (E′) were measured, and E/A and E/E′ were calculated. The study sample was divided into 3 groups: normal weight (body mass index [BMI] <25.0 kg/m 2), overweight (BMI 25.0 to 29.9 kg/m 2), and obese (BMI ≥30 kg/m 2). Results: In multivariate analyses, BMI was independently associated with higher E, A, and E/E′, an indicator of LV filling pressure (all p ≤ 0.01). Overweight and obese had lower E′ (both p < 0.01) and higher E/E′ (both p < 0.01) than normal weight participants. The E/A was lower in obese subjects than in normal weight subjects (p < 0.01). The risk of diastolic dysfunction was significantly higher in overweight subjects (adjusted odds ratio: 1.52, 95% confidence interval: 1.04 to 2.22) and obese subjects (adjusted odds ratio: 1.60, 95% confidence interval: 1.06 to 2.41) compared to normal weight subjects. Conclusions: Increased BMI was associated with worse LV diastolic function independent of LV mass and associated risk factors. The increased risk of LV diastolic dysfunction in both overweight and obese persons may partially account for the increased risk of heart failure associated with both conditions.

KW - diastolic dysfunction

KW - echocardiography

KW - obesity

KW - overweight

KW - risk factors

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