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Obesity and left ventricular diastolic function: noninvasive study in normotensives and newly diagnosed never-treated hypertensives

International Journal of Obesity volume 24, pages 954–958 (2000)Cite this article

Abstract

OBJECTIVE: To evaluate the influence of obesity, per se or associated with hypertension, on left ventricular (LV) diastolic function.

PATIENTS: Thirty-two obese newly-diagnosed never-treated hypertensives; 32 obese normotensives matched for age, sex and BMI with hypertensives; 32 lean newly diagnosed never-treated hypertensives and 32 lean normotensives, matched for age, sex and 24 h blood pressure (BP) with the obese subjects.

METHODS: Twenty-four-hour ambulatory blood pressure monitoring and digitized M-mode LV echocardiograms.

PARAMETERS EVALUATED: Twenty-four-hour, day-time and night-time BP and heart rate, percentage nocturnal BP fall; LV end-diastolic diameter index, septal and posterior wall thickness, LV mass index, peak shortening and lengthening rate of LV diameter, peak thinning rate of LV posterior wall.

RESULTS: A main effect was found for obesity on LV diameter and LV mass and for hypertension on LV mass; LV systolic function was normal in all the subjects and similar among the four groups; LV diastolic function was significantly reduced in both obese groups with respect to lean ones. This difference persisted after correction of diastolic parameters for 24 h BP and heart rate, LV diameter and LV mass index and disappeared only after correction for body mass index. This latter was inversely related with diastolic parameters only in the obese groups.

CONCLUSIONS: Obesity is associated with a preclinical impairment of LV diastolic function in both normotensives and hypertensives; the diastolic impairment is independent of haemodynamic factors, such as 24 h BP and heart rate, and bears no relation to LV geometry in normotensives and only little relation in hypertensives, having therefore to be ascribed to obesity itself.

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References

  1. Kaltman AJ, Goldring RM . Role of circulatory congestion in the cardiorespiratory failure of obesity Am J Med 1976 60: 645–653.

    Article  CAS  Google Scholar 

  2. Hubert HB, Feinleb M, McNamara PM, Castelli WP . Obesity as an independent risk factor for cardiovascular disease. A 26-year follow-up of participants in the Framingham Heart Study Circulation 1983 67: 966–975.

    Article  Google Scholar 

  3. Alexander JK . The cardiomyopathy of obesity Prog Cardiovasc Dis 1985 27: 325–333.

    Article  CAS  Google Scholar 

  4. Carabello BA, Gittens L . Cardiac mechanics and function in obese normotensive persons with normal coronary arteries Am J Cardiol 1987 59: 469–473.

    Article  CAS  Google Scholar 

  5. Mureddu GF, de Simone G, Greco R, Rosato GF, Contaldo F . Left ventricular filling in arterial hypertension. Influence of obesity and hemodynamic and structural confounders Hypertension 1997 29: 544–550.

    Article  CAS  Google Scholar 

  6. Schmieder RE, Messerli FH . Does obesity influence early target organ damage in hypertensive patients? Circulation 1993 87: 1482–1488.

    Article  CAS  Google Scholar 

  7. de Simone G, Devereux RB, Mureddu GF, Roman MJ, Ganau A, Alderman MH, Contaldo F, Laragh JH . Influence of obesity on left ventricular midwall mechanics in arterial hypertension Hypertension 1996 28: 276–283.

    Article  CAS  Google Scholar 

  8. Mureddu GF, de Simone G, Greco R, Rosato GF, Contaldo F . Left ventricular filling pattern in uncomplicated obesity Am J Cardiol 1996 77: 509–514.

    Article  CAS  Google Scholar 

  9. Stoddard MF Tseuda K, Dillon S, Kupersmith J . The influence of obesity on left ventricular filling and systolic function Am Heart J 1992 124: 694–699.

    Article  Google Scholar 

  10. Alpert MA, Lambert CR, Terry BE, Cohen MV, Mukerji V, Massey CV, Hashimi MW, Panayiotou H . Interrelationship of left ventricular mass, systolic function and diastolic filling in normotensive morbidly obese patients Int J Obes Relat Metab Disord 1995 19: 550–557.

    CAS  PubMed  Google Scholar 

  11. Licata G, Scaglione R, Avellone G, Ganguzza A, Corrao S, Arnone S, Di Chiara S . Hemostatic function in young subjects with central obesity: relationship with left ventricular function Metabolism 1995 44: 1417–1421.

    Article  CAS  Google Scholar 

  12. Parrinello g, Scaglione R, Pinto A, Corra S, Cecala M, Di Silvestre G, Amato P, Licata A, Licata G . Central obesity and hypertension. The role of plasma endothelin Am J Hypertens 1996 9: 1186–1191.

    Article  CAS  Google Scholar 

  13. Ferraro S, Perrone Filardi P, Desiderio A, Betocchi S, D'Alto M, Liguori L, Trimigliozzi P, Turco S, Chiariello M . Left ventricular systolic and diastolic function in severe obesity: a radionuclide study Cardiology 1996 87: 347–353.

    Article  CAS  Google Scholar 

  14. Alpert MA, Lambert CR, Terry BE, Cohen MV, Mulekar M, Massey CV, Hashimi MW, Panayiotou H, Mukerji V . Effect of weight loss on left ventricular diastolic filling in morbid obesity Am J Cardiol 1995 76: 1198–1201.

    Article  CAS  Google Scholar 

  15. Alpert MA, Lambert CR, Terry BE, Cohen MV, Mukerji V, Massey CV, Hashimi MW, Panayiotou H . Influence of left ventricular mass on left ventricular diastolic filling in normotensive morbid obesity Am Heart J 1995 130: 1068–1073.

    Article  CAS  Google Scholar 

  16. Berkalp B, Cesur V, Corapcioglu D, Erol C, Baskal N . Obesity and left ventricular diastolic dysfunction Int J Cardiol 1995 52: 23–26.

    Article  CAS  Google Scholar 

  17. Grossman E, Oren S, Messerli FH . Left ventricular filling in the systemic hypertension of obesity Am J Cardiol 1991 68: 57–60.

    Article  CAS  Google Scholar 

  18. Zarich SW, Kowalchuk GJ, McGuire MP, Benotti PN, Mascioli EA, Nesto RW . Left ventricular filling abnormalities in asymptomatic morbid obesity Am J Cardiol 1991 68: 377–381.

    Article  CAS  Google Scholar 

  19. Chakko S, Mayor M, Allison MD, Kessler K, Meterson BJ, Myerberg RJ . Abnormal left ventricular diastolic filling in eccentric left ventricular hypertrophy in obesity Am J Cardiol 1991 68: 95–98.

    Article  CAS  Google Scholar 

  20. Upton MT, Gibson DG . The study of left ventricular function from digitized echocardiograms Prog Cardiovasc Dis 1978 20: 359–384.

    Article  CAS  Google Scholar 

  21. Devereux RB, Reichek N . Echocardiographic determination of left ventricular mass in man: validation of the method Circulation 1977 55: 613–618.

    Article  CAS  Google Scholar 

  22. de Simone G, Daniels SR, Devereux RB, Meyer RA, Roman MJ, de Divitiis O, Alderman MH . Left ventricular mass and body size in normotensive children and adults: assessment of allometric relations and impact of overweight J Am Coll Cardiol 1992 20: 1251–1260.

    Article  CAS  Google Scholar 

  23. Krauss RM, Winston M, for Fletcher BJ, Grundy SM Obesity . Impact on cardiovascular disease Circulation 1998 98: 1472–1476.

    Article  Google Scholar 

  24. Grandi AM, Bignotti M, Gaudio G, Zanzi P, Guasti L, Venco A . Ambulatory blood pressure and left ventricular changes during antihypertensive treatment: perindopril versus isradipine J Cardiovasc Pharmac 1995 26: 737–741.

    Article  CAS  Google Scholar 

  25. Gottdiener JS, Reda DJ, Massie BM, Materson BJ, Williams DW, Anderson RJ . Effect of single-drug therapy on reduction of left ventricular mass in mild to moderate hypertension. Comparison of six antihypertensive agents Circulation 1997 95: 2007–2014.

    Article  CAS  Google Scholar 

  26. Lee CH, Hogan JC, Gibson DG . Diastolic disease in left ventricular hypertrophy: comparison of M-mode and Doppler echocardiography for the assessment of rapid ventricular filling Br Heart J 1991 65: 194–200.

    Article  CAS  Google Scholar 

  27. Inouye I, Massie B, Loge D, Topic N, Silverstein D, Simpson P, Tubau J . Abnormal left ventricular filling: an early finding in mild to moderate systemic hypertension Am J Cardiol 1984 53: 120–126.

    Article  CAS  Google Scholar 

  28. Fouad FM, Slominski M, Tarazi RC . Left ventricular diastolic function in hypertension: relation to left ventricular mass and systolic function J Am Coll Cardiol 1984 3: 1500–1506.

    Article  CAS  Google Scholar 

  29. Shapiro LM, McKenna WJ . Left ventricular hypertrophy: relation of structure to diastolic function in hypertension Br Heart J 1984 51: 637–642.

    Article  CAS  Google Scholar 

  30. Snider AR, Gidding SS, Rocchini AP, Peters J, Farnsworth R . Doppler evaluation of left ventricular diastolic filling in children with systemic hypertension Am J Cardiol 1985 56: 921–926.

    Article  CAS  Google Scholar 

  31. Brilla CG, Janicki JS, Weber KT . Impaired diastolic function and coronary reserve in genetic hypertension Circulation Res 1991 69: 108–114.

    Article  Google Scholar 

  32. Carpenter HM . Myocardial fat infiltration Am Heart J 1962 63: 491–496.

    Article  CAS  Google Scholar 

Download references

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Authors and Affiliations

  1. Department of Clinical and Biological Sciences, Internal Medicine, Faculty of Medicine, University of Insubria, Varese, Italy

    AM Grandi, P Zanzi, E Piantanida, G Gaudio, A Bertolini, L Guasti & A Venco

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  1. AM Grandi
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  2. P Zanzi
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  3. E Piantanida
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  4. G Gaudio
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  5. A Bertolini
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  6. L Guasti
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  7. A Venco
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Correspondence to AM Grandi.

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Grandi, A., Zanzi, P., Piantanida, E. et al. Obesity and left ventricular diastolic function: noninvasive study in normotensives and newly diagnosed never-treated hypertensives. Int J Obes 24, 954–958 (2000). https://doi.org/10.1038/sj.ijo.0801261

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