Left ventricular filling abnormalities in asymptomatic morbid obesity

• Published in: The American journal of cardiology Vol. 68; no. 4; pp. 377 - 381
• Main Authors: Zarich, Stuart W., Kowalchuk, Glen J., McGuire, Maureen P., Benotti, Peter N., Mascioli, Edward A., Nesto, Richard W.
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.08.1991; Elsevier
• Subjects: Adult; Biological and medical sciences; Blood Flow Velocity; Diastole; Echocardiography; Echocardiography, Doppler; Female; Heart Ventricles - diagnostic imaging; Humans; Male; Medical sciences; Metabolic diseases; Middle Aged; Obesity; Obesity, Morbid - physiopathology; Stroke Volume; Ventricular Function, Left; Doppler ultrasound study; Sonography; Human; Obesity; Echocardiography; Cardiovascular disease; Exploration; Metabolic diseases; Asymptomatic; Left ventricle; Blood flow; Hemodynamics; Left ventricle performance
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/0002-9149(91)90835-9

Indexes of left ventricular (LV) diastolic filling were measured by pulse Doppler echocardiography in 16 asymptomatic morbidly obese patients presenting for bariatric surgery and were compared with an age- and sex-matched lean control population. No patient had concomitant disorders known to affect diastolic function. All patients had normal systolic function. LV wall thickness and internal dimension were measured in order to calculate LV mass. Fifty percent of morbidly obese patients had LV diastolic filling abnormalities as assessed by the presence of ≥2 abnormal variables of mitral inflow velocity. The ratio of peak early to peak late (atrial) filling velocity was significantly decreased in obese compared with control patients (1.16 ± 0.26 vs 1.66 ± 0.30, p < 0.001). The peak velocity of early LV diastolic filling was significantly reduced in obese patients (75 ± 15 vs 98 ± 19 cm/s, p < 0.001). The atrial contribution to stroke velocity as assessed by the time-velocity integral of late compared with total LV diastolic filling was significantly increased in obese patients (36 ± 7 vs 27 ± 4%, p < 0.001). Obese patients had significantly increased LV mass (214 ± 45 vs 138 ± 37 g, p < 0.001), even when corrected for body surface area (95 ± 16 vs 76 ± 16 g/m 2, p < 0.002). However, increased LV mass did not correlate with indexes of abnormal diastolic filling in obese patients. These data suggest that abnormalities of diastolic function occur frequently in asymptomatic morbidly obese patients and may represent a subclinical form of cardiomyopathy in the obese patient.