Effect of overweight and obesity on the left ventricular systolic and diastolic functions in patients with acute myocardial infarction

Purpose: The purpose of this study was to evaluate whether a association exits among overweight and obesity and left ventricular systolic and diastolic functions in patients admitted with first ST-elevation myocardial infarction (STEMI). Methods: The present study was performed on 451 consecutive patients diagnosed with first STEMI (376 men, 75 women; mean age 56.1±10.8 years). The patients were classified into three groups based on their body mass index (BMI) as normal weight (BMI < 25 kg/m2), overweight (BMI: 25-29.9 kg/m2) and obese (BMI > 30 kg/m2). Echocardiographic features were evaluated and compared among the three groups. Results: Mitral annulus E velocities were higher in obese individuals than normal weight group (p < 0.01). In contrast, mitral A velocities were lower (p =0.03); consequently, E\A and E'\A' ratios were lower (both p =0.01) in the obese group with respect to normal weight group. When the correction of entire variations existing among the groups were performed using multivariate linear regressions analyses, it turned out that BMI was independently associated with E/A (β= -0.19, p =0.044) and with E'/A' (β= -0.016, p=0.021). Ejection fraction, wall motion score index and myocardial S velocities were comparable among the study groups (p > 0.05). Conclusion: These results suggest that while obesity has no adverse effect on the left ventricular systolic function, it has unfavorable consequences on the left ventricular diastolic function in the patients with first STEMI. In contrast, no unfavorable effects of overweight on the left ventricular systolic and diastolic function were detected.

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Association of smoking and right ventricular function in middle age: CARDIA study

Open Heart ◽

10.1136/openhrt-2020-001270 ◽

2020 ◽

Vol 7 (1) ◽

pp. e001270

Author(s):

Henrique T Moreira ◽

Anderson C Armstrong ◽

Chike C Nwabuo ◽

Henrique D Vasconcellos ◽

Andre Schmidt ◽

...

Keyword(s):

Coronary Artery ◽

Right Ventricular ◽

Diastolic Function ◽

Middle Age ◽

Systolic Function ◽

Left Ventricular ◽

Significant Difference ◽

Former Smokers ◽

Never Smokers ◽

Diastolic Functions

ObjectiveTo evaluate the association of cigarette smoking and right ventricular (RV) systolic and diastolic functions in a population-based cohort of individuals at middle age.MethodsThis cross-sectional study included participants who answered the smoking questionnaire and underwent echocardiography at the Coronary Artery Risk Development in Young Adulthood year 25 examination. RV systolic function was assessed by echocardiographic-derived tricuspid annular plane systolic excursion (TAPSE) and by right ventricular peak systolic velocity (RVS’), while RV diastolic function was evaluated by early right ventricular tissue velocity (RVE’). Multivariable linear regression models assessed the relationship of smoking with RV function, adjusting for age, sex, race, body mass index, systolic blood pressure, total cholesterol, high-density lipoprotein (HDL) cholesterol, diabetes mellitus, alcohol consumption, pulmonary function, left ventricular systolic and diastolic function and coronary artery calcium score.ResultsA total of 3424 participants were included. The mean age was 50±4 years; 57% were female; and 53% were black. There were 2106 (61%) never smokers, 750 (22%) former smokers and 589 (17%) current smokers. In the multivariable analysis, current smokers had significantly lower TAPSE (β=−0.082, SE=0.031, p=0.008), RVS’ (β=−0.343, SE=0.156, p=0.028) and RVE’ (β=−0.715, SE=0.195, p<0.001) compared with never smokers. Former smokers had a significantly lower RVE’ compared with never smokers (β=−0.414, SE=0.162, p=0.011), whereas no significant difference in RV systolic function was found between former smokers and never smokers.ConclusionsIn a large multicenter community-based biracial cohort of middle-aged individuals, smoking was independently related to both worse RV systolic and diastolic functions.

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Obesity and left ventricular mass in children

Paediatrica Indonesiana ◽

10.14238/pi55.4.2015.224-29 ◽

2015 ◽

Vol 55 (4) ◽

pp. 224

Author(s):

Mauliza Mauliza ◽

Muhammad Ali ◽

Melda Deliana ◽

Tina Christina L Tobing

Keyword(s):

Left Ventricular Mass ◽

Interventricular Septum ◽

Left Ventricular ◽

Normal Weight ◽

Obese Group ◽

Internal Diameter ◽

Weight Group ◽

Normal Weight Group ◽

Ventricular Mass ◽

Moderate Positive Correlation

Background Obesity has negative effects on cardiac function during growth leading to increased heart size and mass, as a result of higher stroke volume and cardiac output.Objective To assess for a relationship between obesity and left ventricular mass (LVM) in children, as well as to assess for a correlation between the duration of obesity and LVM.Methods This cross-sectional study was conducted from October 2011 until February 2012 in Medan and included 30 obese and 30 normal weight children, aged 6 to 13 years. All subjects underwent complete echocardiography examinations to assess LVM and other left ventricular parameters. The Devereux formula was used to measure LVM.Results During the study, 65 children underwent echocardiography, but 5 were subsequently excluded. The left ventricular dimensions in the obese group were significantly higher compared to normal weight group with regards to interventricular septum at end diastole (IVSd), interventricular septum at end systole (IVSS), left ventricular internal diameter at end diastole (LVIDd), left ventricular internal diameter at end systole (LVIDs), left ventricular posterior wall thickness at end diastole (LVPWd), left ventricular mass (LVM), and left ventricular mass index (LVMI) (P=0.0001). Duration of obesity and LVM had a moderate, positive correlation (r=0.407).Conclusion There is significantly higher LVM in the obese group than in the normal weight group. The duration of obesity had a moderate, positive correlation to LVM.

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P3444Overweight and obesity in a Mediterranean pediatric population: impact in cardiac chambers morphology and systolic function

European Heart Journal ◽

10.1093/eurheartj/ehz745.0317 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

J Fernandez Cabeza ◽

C U Aristizabal Duque ◽

I M Blancas Sanchez ◽

M Ruiz Ortiz ◽

M Delgado Ortega ◽

...

Keyword(s):

Left Ventricle ◽

Ejection Fraction ◽

Right Ventricle ◽

Systolic Function ◽

Pediatric Population ◽

Left Ventricular ◽

Normal Weight ◽

Left Ventricle Ejection Fraction ◽

Overweight And Obesity ◽

Age And Sex

Abstract Background Obesity is a major medical and public health problem. A high body mass index has been associated with increased mortality and cardiovascular disease morbidity. Obesity in adults is related to hypertrophy and left ventricular dilatation. Previous studies have shown that, in Spain, the prevalence of overweight and obesity in childhood is 26% and 12.6% respectively. The association between obesity and left ventricular morphology has been poorly studied in the pediatric population. Aim To investigate the relationship between childhood obesity and the dimensions of cardiac structures and systolic function in a Mediterranean pediatric population. Methods A random sample of children and adolescents in primary and secondary education was selected, stratified by age, gender and educational centers in a rural town of 2864 inhabitants in southern Spain. Children between 6 and 17 years old were included. A transthoracic echocardiogram was performed for the evaluation of cardiac chambers morphology and systolic function. Results A total of 212 children were studied (10.9±3.0 years old and 51.9% males): 106 (50%) were normal weight, 57 (26.9%) were overweight and 49 (23.1%) were obese. Results are shown in the table. Age and sex were similar in the three groups. Overweight and obesity were related to larger values of left ventricle end-diastolic diameter and volume, left atrial volume and right ventricle basal diameter, and lower values of left ventricle ejection fraction. Normal weight Overweight Obese p Age 10.9±3.2 10.7±2.7 11.0±2.8 0.79 Male (%) 50.9% 49.1% 57.1% 0.69 End-diastolic left ventricle diameter (mm) 41.1±5.5 42.8±5.4 44.2±5.5 0.003 End-diastolic left ventricle volume (mm) 57.9±18.6 64.3±18.3 78.1±22.4 <0.0005 Interventricular septum (mm) 6.3±1.4 6.7±1.3 7.0±1.7 0.01 Left ventricle mass (g) 69.3±30.1 80.9±30.2 94.8±36.5 <0.0005 Left atrium volume (mm) 19.7±6.8 22.6±6.5 27.9±7.4 0.004 Basal right ventricle diameter (mm) 27.6±4.5 28.0±3.9 30.2±4.2 0.001 Left ventricle ejection fraction (%) 65.7±3.6 63.6±4.7 61.5±4.6 <0.0005 Conclusions Overweight and obese children have larger cardiac chambers, higher left ventricular mass, and worse systolic function compared with normal weight children of similar age and sex.

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Left Ventricular Systolic and Diastolic Functions after Cardiac Rehabilitation in Successfully Revascularized Patients with Acute Myocardial Infarction

QJM ◽

10.1093/qjmed/hcaa041.015 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

M I A S Rashed ◽

I M Bastawy ◽

H M Khorshid ◽

A A Sharafeldin

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Cardiac Rehabilitation ◽

Diastolic Function ◽

Speckle Tracking ◽

Left Ventricular ◽

Doppler Imaging ◽

Before And After ◽

2D Speckle Tracking ◽

Diastolic Functions

Abstract Background Coronary artery disease (CAD) is a widely prevalent disease with many adverse sequelae. As survival after myocardial infarction or coronary revascularization has improved, cardiac rehabilitation and secondary prevention services have become more important. Advances in ultrasound such as Doppler imaging, strain or strain rate imaging provide comprehensive information on left ventricle (LV) myocardial contractility. Objective to evaluate the possible early effect of intensive supervised Cardiac rehabilitation on the LV systolic and diastolic functions in patients with acute myocardial infarction (AMI) who had been successfully revascularized by primary percutaneous coronary intervention (PCI) using two dimensional (2D) speckle tracking and doppler imaging. Patients and Methods thirty patients with AMI and successfully revascularized by primary PCI were enrolled in the study. LV global longitudinal strain (LVGLS) analysis was performed using 2D speckle tracking echocardiography before and after Cardiac rehabilitation. LV ejection fraction (EF) was measured using the modified Simpson’s method. Pulsed-wave Doppler at the tip of mitral valve leaflets was also done allowing us to measure the early (E) and late (A) diastolic filling velocities, E/A ratio. The LV tissue velocity was measured by TDI of the lateral mitral annulus (e’) and E/e’ was calculated and LV diastolic dysfunction (DD) grade was estimated. Results There was significant improvement in LVEF measurements before and after Cardiac rehabilitation (47.50 ± 6.42 before vs. 52.17 ± 6.64 after; p = 0.000).The improvement in 2D speckle tracking LVGLS after Cardiac rehabilitation was statistically significant (p = 0.000). the diastolic function as assessed by TDI after a 3-month program of exercise-based cardiac rehabilitation has improved with decrease in the number of patients with DD grade I and increase in the number of normal diastolic function with p-value P < 0.01(highly significant). Conclusion cardiac rehabilitation has beneficial effects on LVGLS, LVEF as well as diastolic function after AMI and successful revascularization.

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Long-Term Cardiac Assessment in a Sample of Adolescent-Onset Anorexia Nervosa

10.21203/rs.3.rs-960338/v1 ◽

2021 ◽

Author(s):

Itziar Flamarique ◽

Bárbara Vidal ◽

Maria Teresa Plana ◽

Susana Andrés-Perpiñá ◽

Miguel Gárriz ◽

...

Keyword(s):

Anorexia Nervosa ◽

Left Ventricular ◽

Normal Weight ◽

Weight Group ◽

Normal Weight Group ◽

2D Echocardiography ◽

Low Weight ◽

Cardiac Assessment ◽

Cardiac Evaluation

Abstract Background: High mortality rates have been reported in patients with anorexia nervosa, mainly due to cardiovascular alterations. The purpose of the present study was to assess cardiac structural and functional abnormalities some 20 years after initial treatment in a sample of adolescent-onset anorexia nervosa (A-AN) and to compare them with matched healthy controls (HC). Methods: A sample of 29 women diagnosed and treated for AN during adolescence (A-AN) were assessed more than 20 years later. A complete cardiac evaluation was carried out including an electrocardiogram (ECG) and a standard 2D echocardiography. Thirty matched HC were also assessed. Results: In the A-AN group, four subjects had a body mass index lower than 18.5 and met full DSM 5 criteria for AN at follow-up (Low-Weight group). They were compared with the rest of the sample (n=25) who had normalized their weight (Normal-Weight group), though some still showed some eating disorder symptoms. Both groups were compared with the HC group. Subjects in the Low-Weight group presented statistically significant decreases in the left ventricular end-diastolic and left atrium dimensions and left ventricular mass in comparison with the Normal-Weight group and the HC. No other differences in cardiac parameters were found between groups. Conclusions Echocardiographic and ECG parameters of adults who had presented A-AN twenty years earlier and currently maintained normal weight were similar to those of HC who had never been treated or diagnosed with AN. Adult subjects with A-AN who still had low weight in the long term present certain cardiac abnormalities similar to those seen in short-lasting disease. More studies are needed to confirm these results in a larger sample.

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Echocardiographic Evaluation of Cardiac Function in Female Patients with Thyroid Disorders

Bosnian Journal of Basic Medical Sciences ◽

10.17305/bjbms.2010.2704 ◽

2010 ◽

Vol 10 (2) ◽

pp. 112-115 ◽

Cited By ~ 4

Author(s):

Almira Hadžović-Džuvo ◽

Elma Kučukalić - Selimović ◽

Emina Nakaš-Ićindić ◽

Senija Rašić ◽

Amela Begić ◽

...

Keyword(s):

Diastolic Function ◽

Thyroid Dysfunction ◽

Systolic Function ◽

Study Groups ◽

Left Ventricular ◽

Left Ventricular Ejection ◽

Cardiac Complications ◽

Ventricular Ejection Fraction ◽

Female Patients ◽

Mitral Inflow

The aim of this study was to assess echocardiographic changes in female patients with untreated dysfunctional thyroid states and whether the therapy aimed to normalize the thyroid dysfunction could lead to improvement in cardiac systolic and diastolic function. The study included 90 female subjects who performed control of thyroid hormonal status at the Institute of Nuclear Medicine at the University of Sarajevo Clinics Centre and who previously were untreated for the thyroid functional disorders. The study sample was divided in three groups based on the thyroid hormones levels: a) hyperthyroid group (n= 30) b) hypothyroid group (n=30) and c) euthyroid (control). Echocardiography measurements were performed on commercially available Toshiba, SSH 140.Before the therapy no statistically significant differences in the peak early and late mitral inflow velocities (E/A) values between the study groups was observed, but the mean left ventricular ejection fraction (LVEF) in hypothyroid group was significantly lower (58,30±1,05) compared to control (64,96±0,71) and hyperthyroid group (64,69±1,31) (p<0,001). In hypothyroid group we found significant increase in mean LVEF (58,30±1,05 vs. 64,95±0,86, p<0,01) and E/A (1,06±0,07 vs. 1,17±0,08; p=0,01) values after the normalization of thyroid hormone status. Thyroid dysfunctional states were not associated with impaired diastolic function, probably due to the short duration of thyroid dysfunction and timely and successful conversion therapy. Systolic function however was significantly reduced in hypothyroid patients but subsequently improved after the adequate therapy. Early diagnostic approach in patients with thyroid dysfunctional states is important for avoidance of cardiac complications that accompany these disorders.

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The diagnostic and prognostic value of right ventricle systolic and diastolic function in inferior myocardial infarction patients

GHMJ (Global Health Management Journal) ◽

10.35898/ghmj-21101 ◽

2018 ◽

Vol 2 (1) ◽

pp. 4

Author(s):

Niniek Purwaningtyas

Keyword(s):

Myocardial Infarction ◽

Diastolic Function ◽

Diagnostic Criteria ◽

Sensitivity And Specificity ◽

Systolic Function ◽

Inferior Myocardial Infarction ◽

Diagnostic Significance ◽

St Segment Elevation ◽

St Segment ◽

Systolic And Diastolic Function

Background: Inferior myocardial infarction (MI) with right ventricular (RV) involvement will increase mortality and morbidity. Data of systolic and diastolic RV function in inferior ST-segment elevation MI (STEMI) are useful to predict the RV involvement. Aims: To evaluate the prognostic and diagnostic significance of RV systolic and diastolic function compared to RVMI diagnostic criteria by electrocardiography in inferior MI patients.Methods: Consecutive patients with first, acute, inferior STEMI were prospectively assessed. The RVMI was defined as an ST-segment elevation ≥ 0.1 mV in lead V4R. Echocardiography was performed within 24 hours of the inferior STEMI symptoms. We assessed the RVMI diagnostic criteria in inferior MI patients using echocardiography.Results: Out of 31 patients (mean age 56.39 ± 9.02 years), RVMI by electrocardiography and echocardiography was found in 18 (37%). Moreover, multivariate analysis showed that two variables — RV systolic and diastolic function, were independent predictors of RVMI in inferior MI patients. Sensitivity and specificity of the RV systolic function were 94.4% and 69.2%, respectively, while RV diastolic functions were 44% and 76.9%, respectively.Conclusion: RV systolic function predict RVMI with relatively high sensitivity and specificity. RV diastolic function predicts RVMI with relatively low sensitivity but with high specificity.

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Physical Characteristics Vary According to Body Mass Index in Japanese Community-Dwelling Elderly Women

Geriatrics ◽

10.3390/geriatrics3040087 ◽

2018 ◽

Vol 3 (4) ◽

pp. 87 ◽

Cited By ~ 3

Author(s):

Koji Nonaka ◽

Shin Murata ◽

Kayoko Shiraiwa ◽

Teppei Abiko ◽

Hideki Nakano ◽

...

Keyword(s):

Body Mass Index ◽

Walking Speed ◽

Elderly Women ◽

Knee Extension ◽

Normal Weight ◽

Physical Characteristics ◽

Community Dwelling ◽

Weight Group ◽

Normal Weight Group ◽

Knee Extension Strength

Background: Body mass index (BMI) is related to health in the elderly. The purpose of this study was to investigate the physical characteristics in underweight, overweight, and obese Japanese community-dwelling elderly women compared to normal-weight elderly women. Methods: The study participants included 212 community-dwelling elderly women. They were categorized as underweight (BMI < 18.5), normal weight (18.5 ≤ BMI ≤ 22.9), overweight (23 ≤ BMI ≤ 24.9), and obese (BMI ≥ 25). Data on skeletal muscle mass index (SMI), number of trunk curl-ups performed within 30 seconds, knee extension strength, one-leg standing time, and walking speed were recorded. Results: In the underweight group, the number of trunk curl-ups was significantly lower than that of the normal-weight group (p = 0.011) and the correlation between knee extension strength and walking speed was relatively higher than in the normal-weight group (r = 0.612 vs. r = 0.471). In the overweight group, the SMI was significantly increased (p < 0.001), but knee extension strength was not increased (p = 0.235) compared to that of the normal-weight group. In the obese group, one-leg standing time was significantly shorter than in the normal-weight group (p = 0.016). Conclusions: Physical characteristics vary according to BMI and these findings are useful in assessing and planning interventional programs to improve and maintain physical function in elderly women.

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The Role of Obesity in Predicting the Clinical Outcomes of COVID-19

Obesity Facts ◽

10.1159/000517180 ◽

2021 ◽

pp. 1-9

Author(s):

Serdar Sahin ◽

Havva Sezer ◽

Ebru Cicek ◽

Yeliz Yagız Ozogul ◽

Murat Yildirim ◽

...

Keyword(s):

Clinical Outcomes ◽

Health Care Providers ◽

Study Groups ◽

Normal Weight ◽

Overweight And Obesity ◽

Care Providers ◽

Significant Difference ◽

Group A ◽

Group B ◽

Group D

Introduction: The aim of this was to describe the predictors of mortality related to COVID-19 infection and to evaluate the association between overweight, obesity, and clinical outcomes of COVID-19. Methods: We included the patients >18 years of age, with at least one positive SARS-CoV-2 reverse transcriptase-polymerase chain reaction. Patients were grouped according to body mass index values as normal weight <25 kg/m2 (Group A), overweight from 25 to <30 kg/m2 (Group B), Class I obesity 30 to <35 kg/m2 (Group C), and ≥35 kg/m2 (Group D). Mortality, clinical outcomes, laboratory parameters, and comorbidities were compared among 4 groups. Results: There was no significant difference among study groups in terms of mortality. Noninvasive mechanical ventilation requirement was higher in group B and D than group A, while it was higher in Group D than Group C (Group B vs. Group A [p = 0.017], Group D vs. Group A [p = 0.001], and Group D vs. Group C [p = 0.016]). Lung involvement was less common in Group A, and presence of hypoxia was more common in Group D (Group B vs. Group A [p = 0.025], Group D vs. Group A [p < 0.001], Group D vs. Group B [p = 0.006], and Group D vs. Group C [p = 0.014]). The hospitalization rate was lower in Group A than in the other groups; in addition, patients in Group D have the highest rate of hospitalization (Group B vs. Group A [p < 0.001], Group C vs. Group A [p < 0.001], Group D vs. Group A [p < 0.001], Group D vs. Group B [p < 0.001], and Group D vs. Group C [p = 0.010]). Conclusion: COVID-19 patients with overweight and obesity presented with more severe clinical findings. Health-care providers should take into account that people living with overweight and obesity are at higher risk for COVID-19 and its complications.

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Implication of anti-angiogenic VEGF-A165b in angiogenesis and systolic function after reperfused myocardial infarction

European Heart Journal ◽

10.1093/ehjci/ehaa946.3645 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

V Marcos Garces ◽

C Rios-Navarro ◽

L Hueso ◽

A Diaz ◽

C Bonanad ◽

...

Keyword(s):

Myocardial Infarction ◽

Adjuvant Therapy ◽

Ejection Fraction ◽

Infarct Size ◽

Systolic Function ◽

Left Ventricular ◽

Left Ventricular Ejection ◽

Funding Source ◽

Coronary Reperfusion ◽

Ventricular Ejection Fraction

Abstract Background Angiogenesis participates in re-establishing microcirculation after myocardial infarction (MI). Purpose In this study, we aim to further understand the role of the anti-angiogenic isoform vascular endothelial growth factor (VEGF)-A165b after MI and explore its potential as a co-adjuvant therapy to coronary reperfusion. Methods Two mice MI models were formed: 1) permanent coronary ligation (non-reperfused MI), 2) transient 45-min coronary occlusion followed by reperfusion (reperfused MI); in both models, animals underwent echocardiography before euthanasia at day 21 after MI induction. Serum and myocardial VEGF-A165b levels were determined. In both experimental MI models, functional and structural implication of VEGF-A165b blockade was assessed. In a cohort of 104 ST-segment elevation MI patients, circulating VEGF-A165b levels were correlated with cardiovascular magnetic resonance-derived left ventricular ejection fraction at 6-months and with the occurrence of adverse events (death, heart failure and/or re-infarction). Results In both models, circulating and myocardial VEGF-A165b presence was increased 21 days after MI induction. Serum VEGF-A165b levels inversely correlated with systolic function evaluated by echocardiography. VEGF-A165b blockage increased capillary density, reduced infarct size, and enhanced left ventricular function in reperfused, but not in non-reperfused MI experiments. In patients, higher VEGF-A165b levels correlated with depressed ejection fraction and worse outcomes. Conclusions In experimental and clinical studies, higher serum VEGF-A165b levels associates with a worse systolic function. Its blockage enhances neoangiogenesis, reduces infarct size, and increases ejection fraction in reperfused, but not in non-reperfused MI experiments. Therefore, VEGF-A165b neutralization represents a potential co-adjuvant therapy to coronary reperfusion. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): This study was funded by “Instituto de Salud Carlos III” and “Fondos Europeos de Desarrollo Regional FEDER” (Exp. PIE15/00013, PI17/01836, PI18/00209 and CIBERCV16/11/00486).

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