Improvement in hypertrophic cardiomyopathy after significant weight loss: case report.
A 17-year-old obese boy found to have familial apical hypertrophic cardiomyopathy on routine screening was enrolled in a weight loss program on the basis of the hypothesis that significant weight loss would improve his cardiac status. He was followed with serial dual-energy x-ray absorptiometry, electrocardiography, echocardiography, and blood pressure and pulse rate measurements. Within 1 year, he lost 49 kg, with a body mass index reduction from 43.6 to 28.1 kg/m2 and associated reductions in systolic blood pressure, diastolic blood pressure, pulse pressure, mean heart rate, rate pressure product, and echocardiographic indices of left ventricular mass that resulted in a change from the initial geometric finding of eccentric left ventricular hypertrophy to a "normal" left ventricular mass with minimal asymmetric apical left ventricular thickening. Significant weight loss in an obese adolescent with presumed familial apical hypertrophic cardiomyopathy was associated with striking improvement in cardiac functional indices, which could have profound implications for long-term cardiovascular risk.
Uwaifo
Gabriel I
GI
Developmental Endocrinology Branch, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA. uwaifog@mail.nih.gov
Fallon
Erica M
EM
Calis
Karim A
KA
Drinkard
Bart
B
McDuffie
Jennifer R
JR
Yanovski
Jack A
JA
D000293:Adolescent; D019440:Anti-Obesity Agents / Q000627:therapeutic use*; D024741:Cardiomyopathy, Hypertrophic, Familial / Q000150:complications* / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D007783:Lactones / Q000627:therapeutic use*; D008297:Male; D009765:Obesity / Q000150:complications* / Q000188:drug therapy* / Q000503:physiopathology; D000077403:Orlistat; D015431:Weight Loss / Q000187:drug effects* / Q000502:physiology
D019440:Anti-Obesity Agents; D007783:Lactones; D000077403:Orlistat