Effect of obesity on cardiovascular remodeling, and aerobic capacity in adults with coarctation of aorta

• Published in: International journal of cardiology Vol. 422; p. 132970
• Main Authors: Ali, Ahmed E., Abdelhalim, Ahmed T., Miranda, William R., ElZalabany, Sara, Moustafa, Amr, Ali, Ali, Connolly, Heidi M., Egbe, Alexander C.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.03.2025
• Subjects: Adult; Aortic Coarctation - diagnostic imaging; Aortic Coarctation - epidemiology; Aortic Coarctation - physiopathology; Body Mass Index; Cardiovascular remodeling; Exercise capacity; Exercise Tolerance - physiology; Female; Humans; Male; Middle Aged; Obesity; Obesity - diagnostic imaging; Obesity - epidemiology; Obesity - physiopathology; Oxygen Consumption - physiology; Vascular Remodeling - physiology; Ventricular Remodeling - physiology; Young Adult; Obesity; RVFWS/RVSP; LVMI; LV; IQR; RWT; Cardiovascular remodeling; LVEDP; RV-PA; COA; TACI; VO2; E/e; Exercise capacity; BMI
• ISSN: 0167-5273; 1874-1754; 1874-1754
• DOI: 10.1016/j.ijcard.2025.132970

We hypothesized that patients with coarctation of aorta (COA) and obesity would have more advanced cardiovascular remodeling and impaired aerobic capacity compared to COA patients without obesity. The purpose of this study was to assess the relationship between obesity, cardiovascular remodeling, and aerobic capacity in adults with repaired COA. The study comprised of 3 groups: (1) Obese COA group (n=177) (COA patients with body mass index [BMI] >30 kg/m2); (2) Non-obese COA group (n=572) (COA patients with BMI ≤30 kg/m2); (3) Control group (n=59) (subjects without structural heart disease and BMI ≤30 kg/m2). Cardiovascular remodeling was assessed using the following indices: (1) Arterial stiffness - total arterial compliance index (TACI). (2) Left ventricular hypertrophy - LV mass (LVM) and relative wall thickness (RWT). (3) LV diastolic function - Doppler-derived estimated LV end-diastolic pressure (LVEDP) and Tau. (4) Right ventricular (RV)-pulmonary artery coupling - RV free wall strain and RV systolic pressure (RVFW/RVSP). Aerobic capacity was assessed using predicted peak oxygen consumption (VO2). The obese COA group had higher LVM, RWT, LVEDP, and Tau, as well as lower RVFWS/RVSP, TACI and peak VO2 compared to non-obese COA group and controls. There was a correlation between BMI and LVM (r = 0.39, p < 0.001), RWT (r = 0.47, p < 0.001), LVEDP (r = 0.43, p < 0.001), tau (r = 0.22, p = 0.008), RVFWS/RVSP (r = − 0.24, p < 0.001), and predicted peak VO2 (r = −0.48, p < 0.001). These findings underscore the cardiovascular implications of obesity in the setting of COA, and provide opportunities for interventions to address obesity, and improve outcomes in this population. •Obese COA patients had worse arterial stiffness, LV hypertrophy, and diastolic dysfunction.•Obese COA patients also had worse RV-PA coupling, and aerobic capacity.•Higher BMI correlated with worse cardiovascular remodeling and impaired aerobic capacity.