title: Early changes of left ventricular geometry and deformational analysis in obese subjects without cardiovascular risk factors: a three-dimensional and speckle tracking echocardiographic study.
abstract: Subclinical myocardial dysfunction has been identified in obese subjects without cardiovascular risks factors and has been defined as "obesity cardiomyopathy". We evaluated left ventricular (LV) function and geometry in obese patients by using a 3 dimensional echocardiography (3DE). We also aimed to look at the influence of ventricular geometry upon functional parameters of the LV by using 3D speckle tracking imaging (3D-STI). 30 consecutive and asymptomatic obese cases (OB group) with no comorbidities were prospectively enrolled. The control group included 30 healthy volunteers (HS group), matched for age and sex. All subjects underwent 3DE and 3D-STI. Ventricular geometry was evaluated with the LV sphericity index (LV SpI) and the LV diastolic volume to mass ratio (LV EDV/Mass ratio). LV Mass was significantly increased in OB group and the LV EDV/Mass ratio had a significantly lower mean value in this group (p < 0.001 and p = 0.002, respectively). LV SpI was significantly reduced in obese subjects (p < 0.001). A significant reduction in longitudinal (GLS), radial (GRS) and area strain (GAS) was observed in OB group (p = 0.001 for all) while circumferential mechanic (GCS) was not different between the two groups (p = 0.052). LV EDV to mass ratio was significantly related to GLS (r = -0.298, p = 0.022) and GAS (r = -0.289, p = 0.026). On multivariate analysis, GRS and GAS were independently related to LV SpI (β = 0.222, p = 0.031 and β = -0.222, p = 0.034, respectively). Geometrical and structural ventricular remodeling negatively influences functional properties of the LV in obese subjects without cardiovascular risks factors. Further studies are needed to assess the prognostic value of our findings.
authors.affiliation: Department of Medical and Pediatric Sciences, University of Catania, Catania, Italy, inemonte@gmail.com.
authors.forename: Ines Paola
authors.initials: IP
authors.lastname: Monte
authors.forename: Sarah
authors.initials: S
authors.lastname: Mangiafico
authors.forename: Sergio
authors.initials: S
authors.lastname: Buccheri
authors.forename: Antonio Andrea
authors.initials: AA
authors.lastname: Arcidiacono
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Lavanco
authors.forename: Fiorella
authors.initials: F
authors.lastname: Privitera
authors.forename: Stefano
authors.initials: S
authors.lastname: Leggio
authors.forename: Wanda
authors.initials: W
authors.lastname: Deste
authors.forename: Corrado
authors.initials: C
authors.lastname: Tamburino
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D042241:Early Diagnosis; D018619:Echocardiography, Doppler, Pulsed; D019560:Echocardiography, Three-Dimensional; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D016277:Ventricular Function, Left; D020257:Ventricular Remodeling; D055815:Young Adult