title: New echocardiographic techniques in the evaluation of left ventricular function in obesity.
abstract: OBJECTIVE
  Obesity has reached global epidemic proportions and is associated with numerous comorbidities, including major cardiovascular (CV) diseases.
  
  
  METHODS
  It has many adverse effects on hemodynamics and CV structure and function: it increases total blood volume and cardiac output, and the cardiac workload is greater. Typically, obese patients have a higher cardiac output but a lower level of total peripheral resistance at any given level of arterial pressure. Most of the increase in cardiac output in obesity is caused by stroke volume, although heart rate typically mildly increases also due to enhanced sympathetic activation.
  
  
  RESULTS
  Over the last few years, experimental investigations have unraveled some important pathogenetic mechanisms that may underlie a specific form of "obesity cardiomyopathy." Bariatric surgery represents an effective alternative to treat obesity when nonsurgical weight loss programs (diet + behavior modifications + regular exercise) have failed. A great numbers of questions are still open in the global comprehension of the pathophysiological interactions between obesity and heart.
  
  
  CONCLUSIONS
  Conventional two-dimensional Doppler echocardiography, integrated by relative new technological ultrasonic approaches, represents the reference technique to study and possibly clarify both the very complex hemodynamic changes induced by obesity and those relative to obesity treatment.
authors: Cardiac,Thoracic and Vascular Department, University of Pisa, Pisa, Italy. vitantonio.dibello@med.unipi.it
authors: Vitantonio
authors: V
authors: Di Bello
authors: Iacopo
authors: I
authors: Fabiani
authors: Lorenzo
authors: L
authors: Conte
authors: Valentina
authors: V
authors: Barletta
authors: Maria Grazia
authors: MG
authors: Delle Donne
authors: Cucco
authors: C
authors: Cuono
authors: Laura Anna
authors: LA
authors: Leo
authors: Frank Lloyd
authors: FL
authors: Dini
authors: Mario
authors: M
authors: Marzilli
authors: Aldo
authors: A
authors: Pinchera
authors: Ferruccio
authors: F
authors: Santini
mesh_terms: D050110:Bariatric Surgery; D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology*; D015150:Echocardiography, Doppler; D006321:Heart / Q000503:physiopathology*; D006339:Heart Rate; D006439:Hemodynamics; D006801:Humans; D009765:Obesity / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D013318:Stroke Volume; D016277:Ventricular Function, Left