Key result
A 12-week low-calorie diet in subjects with obesity significantly improved diastolic function, increasing E/A ratio from 1.2 to 1.4 and reducing A-wave velocity from 65.8 to 57.0 cm/s (p<0.01).
Why the study?
Does a 12-week low-calorie diet improve left ventricular diastolic function in subjects with severe obesity?
Does a 12-week low-calorie diet improve left ventricular diastolic function in subjects with severe obesity?
Absolute Event Rate: 1.4% vs 1.2%
p-value: p=< 0.01
Significant weight loss achieved through a 12-week low-calorie diet partially normalizes left ventricular diastolic dysfunction in patients with severe obesity.
May support dietary weight loss for diastolic dysfunction in obesity; hypothesis-generating without randomization.
Background/objectives: Obesity is independently associated with left ventricular (LV) diastolic dysfunction and altered cardiac morphology. Morbidity and mortality in patients with diastolic dysfunction are similar to values observed in patients with systolic heart failure. We hypothesized that dysfunctional cardiac responses in people with obesity are reversible after weight loss. Thus, we studied the effect of dietary weight reduction on LV diastolic function as well as on cardiac structure using transthoracic echocardiography and tissue Doppler imaging (TDI). Subjects/methods: Thirty-two subjects with obesity underwent a 12-week low-calorie fasting phase of a formula diet. Echocardiographic tissue Doppler indices of diastolic function and measurements of cardiac size were obtained prior to and after the fasting phase. Results: A 12-week diet significantly reduced body mass index from 40.3 ± 6.6 kg/m 2 to 33.2 ± 6.1 kg/m 2 ( p < 0.01). Weight loss was associated with a significant reduction in blood pressure and heart rate. Echocardiography revealed diastolic dysfunction in subjects with obesity, which was improved by dieting. After weight loss, trans-mitral Doppler echocardiography showed a significant reduction in A-wave velocity, from 65.8 ± 19.2 cm/s to 57.0 ± 16.8 cm/s, and an increase in E/A ratio from 1.2 ± 0.4 to 1.4 ± 0.5 ( p < 0.01). TDI displayed a significantly lower a′-wave velocity (10.3 ± 2.3 cm/s and 8.9 ± 1.7 cm/s; p < 0.01). Left atrial and LV dimensions were normal and remained unchanged after weight loss. Conclusion: Obesity is associated with diastolic dysfunction. A 12-week low-calorie diet with successful weight loss can reduce blood pressure and heart rate and partially normalize diastolic dysfunction.
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Stein et al. (2017) studied severe obesity (n=32). Low-calorie formula diet vs. Baseline was evaluated on E/A ratio (diastolic function) (p=< 0.01). A 12-week low-calorie diet in subjects with obesity significantly improved diastolic function, increasing E/A ratio from 1.2 to 1.4 and reducing A-wave velocity from 65.8 to 57.0 cm/s (p<0.01).
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