Association of plasma free fatty acids and left ventricular diastolic function in patients with clinically severe obesity.
BACKGROUND
Obesity is an important contributor to many cardiovascular risk factors and has been associated with abnormalities in cardiac contractile function. Causes of impaired contractile function are not fully understood and may include an oversupply of substrates.


OBJECTIVE
We tested the hypothesis that metabolic dysregulation may adversely influence cardiac function. Specifically, we examined the effects of plasma free fatty acids and insulin sensitivity on left ventricular function in patients with clinically severe obesity.


METHODS
We measured metabolic and cardiac variables in 64 obese patients [body mass index (BMI; in kg/m(2)) > 35], including 2-D complete echocardiogram with M-mode and tissue Doppler imaging, anthropometric measurements, and analysis of blood chemistries.


RESULTS
The median (25th and 75th percentile) age and BMI were 46 y (36, 53 y) and 51.5 (42.5, 56.5), respectively. The prevalence of diabetes, hypertension, and insulin resistance were 38%, 53%, and 90%, respectively. Plasma free fatty acid (FFA) concentrations were elevated in the cohort. No association was observed between insulin sensitivity or anthropometric measurements and left ventricular contractile function. However, FFA concentration was independently associated with diastolic function (r = -0.33, P = 0.01), and 40% of the cohort showed age-adjusted diastolic impairment as measured by tissue Doppler imaging.


CONCLUSIONS
The negative association between FFA and diastolic function, in the setting of insulin resistance, suggests that excess FFA may exert a lipotoxic effect on the heart.
Leichman
Joshua G
JG
Division of Cardiology, University of Texas, Houston Medical School, Houston, TX, USA.
Aguilar
David
D
King
Terri M
TM
Vlada
Adrian
A
Reyes
Manuel
M
Taegtmeyer
Heinrich
H
D000328:Adult; D000704:Analysis of Variance; D000886:Anthropometry; D001774:Blood Chemical Analysis; D015992:Body Mass Index; D015331:Cohort Studies; D003971:Diastole; D015150:Echocardiography, Doppler; D005230:Fatty Acids, Nonesterified / Q000097:blood*; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000097:blood* / Q000000981:diagnostic imaging / Q000503:physiopathology*; D016277:Ventricular Function, Left
D005230:Fatty Acids, Nonesterified