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Background: The concept of a cardiomyopathy due to obesity is based mainly on relatively small cross sectional studies that are hampered by referral bias.
Methods: We analyzed 254 severely obese subjects (BMI ≥ 35 kg/m2) participating in a longitudinal study of obesity and CV disease. All of the subjects had echocardiography performed at baseline and after a mean follow up of 10 years. Demographic, clinical and laboratory features were determined at baseline, 2-, 6- and 10-year follow up. Total exposure to obesity during the study period was defined by the area under the curve of the BMI at each of the 4 visits.
Results: At enrollment, mean age was 46, 79% were female, mean BMI was 43 kg/m2, 27% had diabetes, 49% had hypertension and 53% had hyperlipidemia. Between baseline and 10 years, there were significant increases in left ventricular (LV) mass and LA volume, and significant decreases in E/A ratio and E deceleration time (Table). However, there were no significant changes in LV end diastolic volume, relative wall thickness, LV EF, RV fractional area change, LA dimension or E/e’. Significant predictors of the change in LV mass were gender, baseline BMI, change in BMI and BMI exposure, but not smoking, or presence of HTN or diabetes.
Conclusions: Over 10 years of follow up, severely obese patients with persistent obesity had modest changes in cardiac structure and function that were most strongly related to gender, age and change in BMI over time. These changes are not classical for an evolving dilated cardiomyopathy.
Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:45 a.m.
Session Title: Making Progress in Understanding Heart Failure
Abstract Category: 13. Heart Failure and Cardiomyopathies: Clinical
Presentation Number: 1123-268
- 2017 American College of Cardiology Foundation