Author + information
- Received August 23, 2010
- Revision received October 26, 2010
- Accepted October 28, 2010
- Published online March 22, 2011.
- Cesare Russo, MD⁎,
- Zhezhen Jin, PhD†,
- Shunichi Homma, MD⁎,
- Tatjana Rundek, MD‡,
- Mitchell S.V. Elkind, MD§,
- Ralph L. Sacco, MD‡∥ and
- Marco R. Di Tullio, MD⁎,⁎ ()
- ↵⁎Reprint requests and correspondence:
Dr. Marco R. Di Tullio, Division of Cardiology, Columbia University, College of Physicians and Surgeons, PH3-342, 630 West 168th Street, New York, New York 10032
Objectives The purpose of this study was to assess the independent effect of increased body size on left ventricular (LV) diastolic function.
Background Obese and overweight persons are at increased risk of heart failure. Left ventricular diastolic dysfunction is an asymptomatic condition associated with future heart failure. It is unclear whether obesity and overweight are independently associated with LV diastolic dysfunction.
Methods The LV diastolic function was evaluated in 950 participants from the CABL (Cardiovascular Abnormalities and Brain Lesions) study by traditional and tissue Doppler imaging. Peak early transmitral diastolic flow velocity (E), late transmitral diastolic flow velocity (A), and early diastolic mitral annulus velocity (E′) were measured, and E/A and E/E′ were calculated. The study sample was divided into 3 groups: normal weight (body mass index [BMI] <25.0 kg/m2), overweight (BMI 25.0 to 29.9 kg/m2), and obese (BMI ≥30 kg/m2).
Results In multivariate analyses, BMI was independently associated with higher E, A, and E/E′, an indicator of LV filling pressure (all p ≤ 0.01). Overweight and obese had lower E′ (both p < 0.01) and higher E/E′ (both p < 0.01) than normal weight participants. The E/A was lower in obese subjects than in normal weight subjects (p < 0.01). The risk of diastolic dysfunction was significantly higher in overweight subjects (adjusted odds ratio: 1.52, 95% confidence interval: 1.04 to 2.22) and obese subjects (adjusted odds ratio: 1.60, 95% confidence interval: 1.06 to 2.41) compared to normal weight subjects.
Conclusions Increased BMI was associated with worse LV diastolic function independent of LV mass and associated risk factors. The increased risk of LV diastolic dysfunction in both overweight and obese persons may partially account for the increased risk of heart failure associated with both conditions.
This work was supported by the National Institute of Neurological Disorders and Stroke (grant number R01 NS36286 to Dr. Di Tullio, and grant number R37 NS29993 to Drs. Sacco and Elkind). The authors have reported that they have no relationships to disclose.
- Received August 23, 2010.
- Revision received October 26, 2010.
- Accepted October 28, 2010.
- American College of Cardiology Foundation