Obesity and left ventricular diastolic dysfunction

To assess the influence of obesity on left ventricular function, 20 obese women (mean body mass index (BMI) 33.8 ± 3.1 kg/m2 and mean age 31.1 ± 2.4 years) without evidence of heart disease were evaluated by echocardiography. Obese subjects had greater left ventricular mass index (103 ± 22 g/m2, 76 ± 18 g/m2; P < 0.0001) and augmented fractional shortening (39 ± 2.6%, 36 ± 0.1%; P < 0,0001) than normals. Isovolumic relaxation time was prolonged in the obese group (92 ± 11 ms) as compared with the control group (76 ± 11 ms; P < 0.0001). The ratio of peak early and atrial filling velocities was significantly lower (1.2 ± 0.4, 1.9 ± 0.6; P < 0.0001) and atrial contribution was higher (39 ± 9, 25 ± 5; P < 0.0001) in obese subjects than in normals. Shortened deceleration time was measured in obese subjects (142 ± 30, 179 ± 20 ms; P < 0.0001). In conclusion, obesity causes relaxation and early filling abnormalities and diastolic filling is compensated by augmented atrial contribution. Diastolic dysfunction is an early indicator of cardiac involvement in obesity.