Obesity independently increased global wasted work by 19% and decreased global work efficiency by 1.3% in patients without known cardiovascular disease.
Obesity is an independent predictor of impaired myocardial efficiency, as measured by myocardial work, in patients without known cardiovascular disease.
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Abstract Background Myocardial work (MW) is an emerging echocardiographic tool that quantifies left ventricular function through pressure–strain loops. Validated against invasive pressure–volume measurements, MW provides a comprehensive assessment of myocardial performance. In this study, we evaluated the prevalence and severity of subclinical left ventricular dysfunction in a general population and examined its association with cardiovascular (CV) risk factors. Methods We conducted a retrospective, single-center analysis of patients with no known cardiovascular disease, who underwent MW assessment between January 2022 and November 2024. Participants were characterized based on traditional CV risk factors, and MW parameters were analyzed, including global constructive work (GCW), global wasted work (GWW), global work index (GWI), and global work efficiency (GWE). Results A total of 822 patients were included (52.8% male, mean age 63 ± 11 years, BMI 27.5 ± 3.8 kg/m²). Among them, 21% were obese, 14% had diabetes, 65% had hypercholesterolemia, and 39% were smokers or recent quitters. Only 15% had no CV risk factors. Basal clinical and echocardiographic parameters were within the normal range: SBP 124±16mmHg, DBP 74±10, LVEF 59.7±7, E/e’ 7.3±2.5, PASP 23±6mmHg, GWE 91.7±4.4%, GWI 1551±305mmHg%, GCW 1903±343mmHg% and GWW 165±95mmHg%. Univariable analysis revealed that GWW and GWE were significantly associated with sex, age, obesity, hypercholesterolemia, and smoking (Table 1). Multivariable analysis identified obesity and hypercholesterolemia as independent predictors of GWW and GWE, explaining 8% of the variance (partial η² = 0.08). After adjusting for age and sex, obesity remained the sole independent determinant of GWW and GWE. Obese patients had higher GWW (189 ± 109 vs. 159 ± 91 mmHg%, p = 0.028) and lower GWE (90.7 ± 4.9 vs. 92.0 ± 4.3%, p = 0.007). Conclusion This study highlights that obesity is a key, independent contributor to impaired myocardial efficiency, reflected by higher GWW and lower GWE. These findings underscore the importance of targeting obesity as a modifiable risk factor to mitigate early left ventricular dysfunction and improve cardiovascular outcomes.
Cotrim et al. (Thu,) reported a other. Obesity independently increased global wasted work by 19% and decreased global work efficiency by 1.3% in patients without known cardiovascular disease.