Biomedical Science Letters (대한의생명과학회지)

The Korean Society for Biomedical Laboratory Sciences (대한의생명과학회)
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Difference of The Cardiac Structure and Function Depending on Obesity Level of Healthy Adults

  • Shin, Kyung-A (Department of Laboratory Medicine Bundang Jesaeng Hospital) ;
  • Hong, Seung-Bok (Department of Clinical Laboratory Sciences, Juseong University)
  • Received : 2011.05.02
  • Accepted : 2011.06.10
  • Published : 2011.06.30
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Abstract

The purpose of this study was to find out any difference and correlation between the cardiac structure and its function according to the level of obesity as evaluated by waist measurement and BMI (body mass index) in healthy adults. For research subjects, the study selected a final 519 subjects excluding 198 subjects aged 55 or over out of 717 subjects who received echocardiography through a medical checkup at J General Hospital. For the criteria for obesity, men were defined as being obese in case their waist measurement was over 90 cm, whereas women were defined as being obese in case their waist measurement was over 80 cm. Also, regarding the BMI criteria, in case a person's BMI was 30 kg/$m^2$, the subject was classified as belonging to an obese group, and in case a person's BMI was between 25 kg/$m^2$ and 30 kg/$m^2$, the subject was classified as belonging to an overweight group. Concerning the evaluation of cardiac structure and function, they were evaluated using two-dimensional, M-mode, doppler echocardiography. According to the stage of obesity in accordance with waist measurement and BMI, the cardiac structure showed both eccentric and centripetal changes, and the cardiac function was also discovered to show differences according to the stage of obesity. In addition, also in the overweight group, which is a prior stage to obesity, out of the criteria for obesity classification according to BMI, there were differences in the cardiac structure and function. Also, both the waist measurement and BMI were found to have a correlation with cardiac structure and diastolic function. Consequently, cardiac structure and function are correlated with BMI and waist measurement, which are anthropometrical variables, and obesity is assumed to induce not only structural change but also functional change of the heart.

Keywords

References

  1. Aasum E, Hafstad AD, Severson DL, Larsen TS. Age-dependent changes in metabolism, contractile function, and ischemic sensitivity in hearts from db/db mice. Diabetes 2003. 52: 434-441. https://doi.org/10.2337/diabetes.52.2.434
  2. Alaud-din A, Meterissian S, Lisbona R, MacLean LD, Forse RA. Assessment of cardiac function in patients who were morbidly obese. Surgery 1990. 108: 809-818.
  3. Alpert MA, Terry BE, Kelly DL. Effect of weight loss on cardiac chamber size, wall thickness and left ventricular function in morbid obesity. Am J Cardiol. 1985. 55: 783-786. https://doi.org/10.1016/0002-9149(85)90156-0
  4. Arkin JM, Alsdorf R, Bigornia S, Palmisano J, Beal R, Istfan N, Hess D, Apovian CM, Gokce N. Relation of cumulative weight burden to vascular endothelial dysfunction in obesity. Am J Cardiol. 2008. 101: 98-101. https://doi.org/10.1016/j.amjcard.2007.07.055
  5. Avelar ET, Cloward V, Walker JM, Farney RJ, Strong M, Pendleton RC, Segerson N, Adams TD, Gress RE, Hunt SC, Litwin SE. Left ventricular hypertrophy in severe obesity: interactions among blood pressure, nocturnal hypoxemia, and body mass. Hypertension 2007. 49: 34-39. https://doi.org/10.1161/HYPERTENSIONAHA.107.089862
  6. Chadha DS, Gupta N, Goel K, Pandey RM, Kondal D, Ganjoo RK, Misra A. Impact of obesity on the left ventricular functions and morphology of healthy Asian Indians. Metab Syndr Relat Disord. 2009. 7: 151-158. https://doi.org/10.1089/met.2008.0054
  7. Chakko S, Mayor M, Allison MD, Kessler KM, Materson BJ, Myerburg RJ. Abnormal left ventricular diastolic filling in eccentric left ventricular hypertrophy of obesity. Am J Cardiol. 1991. 68: 95-98. https://doi.org/10.1016/0002-9149(91)90718-Z
  8. de las Fuentes LA, Waggoner D, Brown AL, Davila-Roman VG. Plasma triglyceride level is an independent predictor of altered left ventricular relaxation. J Am Soc Echocardiogr. 2005. 18: 1285-1291. https://doi.org/10.1016/j.echo.2005.05.002
  9. de las Fuentes LA, Waggoner D, Mohammed BS, Stein RI, Miller BV 3rd, Foster GD, Wyatt HR, Klein S, Davila-Roman VG. Effect of moderate diet-induced weight loss and weight regain on cardiovascular structure and function. J Am Coll Cardiol. 2009. 54: 2376-2381. https://doi.org/10.1016/j.jacc.2009.07.054
  10. de Simone GR, Devereux B, Maggioni AP, Gorini M, de Divitiis O, Verdecchia P. Different normalizations for body size and population attributable risk of left ventricular hypertrophy: the MAVI study. Am J Hypertens. 2005. 18: 1288-1293. https://doi.org/10.1016/j.amjhyper.2005.05.027
  11. Di Bello V, Santini F, Di Cori A, Pucci A, Palagi C, Delle Donne MG, Fierabracci P, Marsili A, Talini E, Giannetti M, Biadi O, Balbarini A, Mariani M, Pinchera A. Obesity cardiomyopathy: is it a reality? An ultrasonic tissue characterization study. J Am Soc Echocardiogr. 2006. 19: 1063-1071. https://doi.org/10.1016/j.echo.2006.03.033
  12. Domanski MJ, Jablonski KA, Rice MM, Fowler SE, Braunwald E. Obesity and cardiovascular events in patients with established coronary disease. Eur Heart J. 2006. 27: 1416-1422. https://doi.org/10.1093/eurheartj/ehl022
  13. Dorbala S, Crugnale S, Yang D, Di Carli MF. Effect of body mass index on left ventricular cavity size and ejection fraction. Am J Cardiol. 2006. 97: 725-729. https://doi.org/10.1016/j.amjcard.2005.09.122
  14. Engeli S, Bohnke J, Gorzelniak K, Janke J, Schling P, Bader M, Luft FC, Sharma AM. Weight loss and the renin-angiotensin-aldosterone system. Hypertension 2003. 43: 356-362.
  15. Esposito K, Pontillo A, Di Palo C, Giugliano G, Masella M, Marfella M, Giugliano D. Effect of weight loss and lifestyle changes on vascular inflammatory markers in obese women: a randomized trial. JAMA. 2003. 289: 1799-1804. https://doi.org/10.1001/jama.289.14.1799
  16. Flegal KM, Graubard BI, Williamson DF, Gail MH. Excess deaths associated with underweight, overweight, and obesity. JAMA. 2005. 293: 1861-1867. https://doi.org/10.1001/jama.293.15.1861
  17. Haslam D, James W. Obesity. Lancet 2005. 366: 1197-1209. https://doi.org/10.1016/S0140-6736(05)67483-1
  18. Hinderliter A, Sherwood A, Gullette EC, Babyak M, Waugh R, Georgiades A, Blumenthal JA. Reduction of left ventricular hypertrophy after exercise and weight loss in overweight patients with mild hypertension. Arch Intern Med. 2002. 162: 1333-1339. https://doi.org/10.1001/archinte.162.12.1333
  19. Iacobellis G, Ribaudo MC, Zappaterreno A, Iannucci CV, Di Mario U, Leonetti F. Adapted changes in left ventricular structure and function in severe uncomplicated obesity. Obes Res. 2004a. 12: 1616-1621. https://doi.org/10.1038/oby.2004.201
  20. Iacobellis G, Ribaudo MC, Zappaterreno A, Iannucci CV, Leonetti F. Relation between epicardial adipose tissue and left ventricular mass. Am J Cardiol. 2004b. 94: 1084-1087. https://doi.org/10.1016/j.amjcard.2004.06.075
  21. Jassen I, Katzmarzyk P, Ross R. Waist circumference and not body mass index explains obesity-related health risk. Am J Clin Nutr. 2004. 79: 379-384. https://doi.org/10.1093/ajcn/79.3.379
  22. Kim SH, Choi SI, Shin JH, Lim HK, Lee BH, Kim MK, Choi BY. Aterial Stiffness and Abdominal Obesity are Associated with the Relaxation Abnormality of Left Ventricle in Human Hypertension. Korean Circ J. 2006. 36: 221-228. https://doi.org/10.4070/kcj.2006.36.3.221
  23. Krishnan R, Becker RJ, Beighley LM, Lopez-Candales A. Impact of body mass index on markers of left ventricular thickness and mass calculation: results of a pilot analysis. Echocardiography 2005. 22: 203-210. https://doi.org/10.1111/j.0742-2822.2005.03138.x
  24. Lauer MS, Anderson KM, Kannel WB, Levy D. The impact of obesity on left ventricular mass and geometry. The Framingham Heart Study. JAMA. 1991. 266: 231-236. https://doi.org/10.1001/jama.1991.03470020057032
  25. Levy D, Garrison RJ, Savage DD, Kannel WB, Castelli WP. Prognostic implications of echocardiographically determined left ventricular mass in the Framingham Heart Study. N Engl J Med. 1990. 322: 1561-1566. https://doi.org/10.1056/NEJM199005313222203
  26. Libhaber CD, Norton GR, Majane OH, Libhaber E, Essop MR, Brooksbank RM, Maseko M, Woodiwiss AJ. Contribution of central and general adiposity to abnormal left ventricular diastolic function in a community sample with a high prevalence of obesity. Am J Cardiol. 2009. 104: 1527-1533. https://doi.org/10.1016/j.amjcard.2009.07.020
  27. Massie BM. Obesity and heart failure-risk factor or mechanism? N Engl J Med. 2002. 347: 358-359. https://doi.org/10.1056/NEJMe020065
  28. Mavri A, Stegnar M, Sentocnik JT, Videcnik V. Impact of weight reduction on early carotid atherosclerosis in obese premenopausal women. Obes Res. 2001. 9: 511-516. https://doi.org/10.1038/oby.2001.67
  29. Peterson LR, Herrero P, Schechtman KB, Racette SB, Waggoner AD, Kisrieva-Ware Z, Dence C, Klein S, Marsala J, Meyer T, Gropler RJ. Effect of obesity and insulin resistance on myocardial substrate metabolism and efficiency in young women. Circulation 2004a. 109: 2191-2196. https://doi.org/10.1161/01.CIR.0000127959.28627.F8
  30. Peterson LR, Waggoner AD, Schechtman KB, Meyer T, Gropler RJ, Barzilai B, Davila-Roman VG. Alterations in left ventricular structure and function in young healthy obese women: assessment by echocardiography and tissue Doppler imaging. J Am Coll Cardiol. 2004b. 43: 1399-1404. https://doi.org/10.1016/j.jacc.2003.10.062
  31. Powell BD, Redfield MM, Bybee KA, Freeman WK, Rihal CS. Association of obesity with left ventricular remodeling and diastolic dysfunction in patients without coronary artery disease. Am J Cardiol. 2006. 98: 116-120. https://doi.org/10.1016/j.amjcard.2006.01.063
  32. Ryu SK, Choi JW, Cho YB. The Early Change of Left Ventricular Function in Overweight and Obese Patients: Analysis With Tissue Doppler Echocardiography. Korean Circ J. 2008. 38: 270-275. https://doi.org/10.4070/kcj.2008.38.5.270
  33. Sharpe JA, Naylor LH, Jones TW, Davis EA, O'Driscoll G, Ramsay JM, Green DJ. Impact of obesity on diastolic function in subjects < or = 16 years of age. Am J Cardiol. 2006. 98: 691-693. https://doi.org/10.1016/j.amjcard.2006.03.052
  34. Sung JK, Kim JY. Obesity and Preclinical Changes of Cardiac Geometry and Function. Korean Circ J. 2010. 40: 55-61. https://doi.org/10.4070/kcj.2010.40.2.55
  35. Wong CY, O'Moore-Sullivan T, Leano R, Byrne N, Beller E, Marwick TH. Alterations of left ventricular myocardial characteristics associated with obesity. Circulation 2004. 110: 3081-3087. https://doi.org/10.1161/01.CIR.0000147184.13872.0F
  36. World Health Organization. West Pacific Region. The Asia-pacific Perspective: redefining obesity and its treatment. International Obesity Task Force 2000. 2: 15-21.
  37. Yan LL, Daviglus ML, Liu K, Stamler J, Wang R, Pirzada A, Garside DB, Dyer AR, Van Horn L, Liao Y, Fries JF, Greenland P. Midlife body mass index and hospitalization and mortality in older age. JAMA. 2006. 295: 190-198. https://doi.org/10.1001/jama.295.2.190
  38. Yusuf S, Hawken S, Ounpuu S, Bautista L, Franzosi MG, Commerford P, Lang CC, Rumboldt Z, Onen CL, Lisheng L, Tanomsup S, Wangai P, Razak F, Sharma AM, Anand SS. Interheart Study Investigators. Obesity and the risk of myocardial infarction in 27,000 participants from 52 countries: a case-control study. Lancet 2005. 366: 1640-1649. https://doi.org/10.1016/S0140-6736(05)67663-5
  39. Zhou YT, Grayburn P, Karim A, Shimabukuro M, Higa M, Baetens D, Orci L, Unger RH. Lipotoxic heart disease in obese rats: implications for human obesity. Proc Natl Acad Sci. 2000. 97: 1784-1789. https://doi.org/10.1073/pnas.97.4.1784