Key result
Obesity and poor metabolic health status were associated with subclinical decrements in left ventricular systolic and diastolic function, including worse global longitudinal strain and higher left ventricular mass index (P<0.001).
Why the study?
Obesity and metabolic syndrome are linked to cardiac dysfunction and heart failure, but their effects on LV structure and function in people without overt heart disease required assessment.
Does obesity and poor metabolic health status worsen subclinical left ventricular structure and function in adults without overt heart disease?
Cross-Sectional (n=789)
No
Does obesity and poor metabolic health status worsen subclinical left ventricular structure and function in adults without overt heart disease?
p-value: p=<0.001
Obesity and poor metabolic health are associated with subclinical left ventricular systolic and diastolic dysfunction, highlighting the importance of metabolic health even in patients with preserved ejection fraction and no overt heart disease.
Supports metabolic optimization in obesity; leaves open whether interventions reverse subclinical LV changes.
BACKGROUND: Obesity and metabolic syndrome (MetS) are associated with high risk of cardiac dysfunction and heart failure. We assessed the effect of obesity and metabolic health status on left ventricular (LV) structure and function in subjects without overt heart disease. METHODS: In 789 subjects (58.8±13.0 years, 50.7% males) without overt heart disease, LV morphology and function were compared among 6 groups stratified by body mass index (BMI) (normal weight, overweight and obese) and metabolic health status (meeting ≤1 criterion of MetS excluding waist circumference defined as metabolically healthy; otherwise, metabolically unhealthy). RESULTS: LV ejection fraction (LVEF) was not different among the 6 groups (P>0.05). However, high BMI and poor metabolic health were associated with poorer global longitudinal strain (GLS), higher LV mass index (LVMI) and higher E/e' (P<0.001). Poor metabolic health status was associated with greater adverse changes in LV structure and function than obesity, and among MetS components, high systolic blood pressure (SBP) showed the greatest impact. Higher SBP, BMI and triglycerides were independently associated with worse GLS, and higher SBP was also associated with worse LVMI and E/e´. GLS, LVMI and E/e´ worsened in proportion to the number of MetS criteria or continuous MetS scores. Adverse myocardial changes associated with obesity were significant in the metabolically healthy group, but not in the metabolically unhealthy group. CONCLUSIONS: Obesity and poor metabolic health status were associated with subclinical decrement in LV systolic and diastolic function, and higher LV mass, but not with LVEF, in subjects without overt heart disease.
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Lee et al. (2019) conducted a cross-sectional in Without overt heart disease (n=789). Obesity and poor metabolic health status vs. Normal weight and metabolically healthy was evaluated on Subclinical left ventricular structure and function (GLS, LVMI, E/e') (p=<0.001). Obesity and poor metabolic health status were associated with subclinical decrements in left ventricular systolic and diastolic function, including worse global longitudinal strain and higher left ventricular mass index (P<0.001).
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