Obesity influences left ventricular filling in essential hypertension.

To verify whether obesity influences left ventricular (LV) filling in arterial hypertension, Doppler LV diastolic flow was compared in 18 hypertensive obese patients (OH, 7 men, 11 women; age: 49±15 years; body mass index (BMI): 39±7; blood pressure (BP): 162±28/98±10 mmHg), 31 normotensive obese subjects (ON, 10 men, 21 women, age: 33±13 years; BMI:37±6; BP=125±14/74±10 mmHg) and 37 normotensive normal-weight controls (NN; 10 men, 21 women, age: 36±14 years; BMI:23±4; BP=120±14/72±10 mmHg), by ANOVA after adjusting (ANCOVA) for confounders (age, systolic and diastolic BP and R-R time). OH exhibited higher LV mass/height2.7 (LVMI; 53±17 g/m2.7) than ON (36±10 g/m2.7) and NN (26±8 g/m2.7) (both p<0.0001), and similar fractional shortening. In early diastole, isovolumic relaxation time (IVRT) was prolonged in OH (85±22 msec) and in ON (85±21 msec, vs 59±14 msec in NN, both p<0.0001), and transmitral peak E velocity (E) was lower (63±13 cm/sec in OH and 63±16 cm/sec in ON vs 72±14 cm/sec in NN, both p<0.05), independently of age, BP and R-R time. Both IVRT and E were related to LVMI (both p<0.04), but this relation disappeared after controling for BMI. In late diastole, E decelaration time was prolonged and atrial filling fraction greater in both OH (212±52 msec and 36±9%) and ON (173±45 msec and 35±11%), than in NN (149±23 msec and 31±7%, all p<0.05) independently of confounders. Thus 1) LV filling abnormalities in obese patients with hypertension are mainly due to obesity; 2) presence of obesity may affect assessment of LV filling in hypertension.