Adapted changes in left ventricular structure and function in severe uncomplicated obesity.
OBJECTIVE
A massive amount of fat tissue, as that observed in obese subjects with BMI over 50 kg/m(2), could affect cardiac morphology and performance, but few data on this issue are available. We sought to evaluate cardiac structure and function in uncomplicated severely obese subjects.


METHODS
We studied 55 uncomplicated severely obese patients, 40 women, 15 men, mean age 35.5 +/- 10.2 years, BMI 51.2 +/- 8.8 kg/m(2), range 43 to 81 kg/m(2), with a history of fat excess of at least 10 years, and 55 age-matched normal-weight subjects (40 women, 15 men, mean BMI 23.8 +/- 1.2 kg/m(2)) as a control group. Each subject underwent an echocardiogram to evaluate left ventricular (LV) mass and geometry and systolic and diastolic function.


RESULTS
Severely obese subjects showed greater LV mass and indexed LV mass than normal-weight subjects (p < 0.01 for all parameters). Nevertheless, LV mass was appropriate for sex, height(2.7), and stroke work in most (77%) uncomplicated severely obese subjects. In addition, no significant difference in LV mass indices and LV mass appropriateness between obese subjects with BMI > or = 50 kg/m(2) and those with BMI < or = 50 kg/m(2) was found. Obese subjects also showed higher ejection fraction and midwall shortening than normal-weight subjects (p = 0.05 and p < 0.01, respectively), suggesting a hyperdynamic systolic function. No significant difference in systolic performance between obese subjects with BMI > or = 50 kg/m(2) and those with BMI < or = 50 kg/m(2) was seen.


CONCLUSIONS
Our data show that uncomplicated severe obesity, despite the massive fat tissue amount, is associated largely with adapted and appropriate changes in cardiac structure and function.
Iacobellis
Gianluca
G
Center for Human Nutrition, The University of Texas Southwestern Medical Center at Dallas, 5323 Harry Hines Boulevard, Dallas, Texas 75390-9052, USA. gianluca.iaco@tin.it
Ribaudo
Maria Cristina
MC
Zappaterreno
Alessandra
A
Iannucci
Concetta Valeria
CV
Di Mario
Umberto
U
Leonetti
Frida
F
D000222:Adaptation, Physiological; D000328:Adult; D015992:Body Mass Index; D003971:Diastole / Q000502:physiology; D004452:Echocardiography; D005260:Female; D006321:Heart / Q000033:anatomy & histology / Q000502:physiology*; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D008297:Male; D009206:Myocardium / Q000473:pathology; D009767:Obesity, Morbid / Q000503:physiopathology*; D013599:Systole / Q000502:physiology; D016277:Ventricular Function, Left / Q000502:physiology*