The Relationships between Body Mass Index and Left Ventricular Diastolic Function in a Structurally Normal Heart with Normal Ejection Fraction
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Background: We conducted research to determine the effect of the weight on left ventricular (LV) diastolic function in Asians,who are at greater risk of cardiovascular events compared to individuals from Western countries with similar body mass indices(BMIs). Methods: We studied 543 participants with structurally normal hearts and normal ejection fractions. Participants were classifiedas normal-weight (BMI < 23.0 kg/m2), overweight (BMI 23.0–27.4 kg/m2), or obese (BMI ≥ 27.5 kg/m2). Peak E velocity,peak A velocity, and E’ velocity were measured and E/E’ was calculated. Results: Overweight participants had lower E than normal-weight participants (p = 0.001). E’ velocities in overweight andobese participants were less than those in normal weight participants (both p < 0.001). The E/E’ ratio in obese participants washigher compared to the value in normal-weight participants (p < 0.001) and overweight participants (p = 0.025). BMI was associatedwith E (R = -0.108), A (R = 0.123), E’ (R = -0.229), and E/E’ ratio (R = 0.138) (all p < 0.05). In multivariate analyses,BMI was independently associated with higher A, lower E’, and higher E/E’. The risk of diastolic dysfunction was significantlyhigher among overweight [adjusted odds ratio: 2.088; 95% confidence interval (CI): 1.348–3.235; p = 0.001] and obese participants(adjusted odds ratio: 5.910; 95% CI: 2.871–12.162; p < 0.001) compared to normal-weight participants. Conclusion: Obesity and overweight independently predicted diastolic dysfunction. An optimal body weight lower than theuniversal cut-off is reasonable for preventing LV heart failure in Asians.
Abstract
Background: We conducted research to determine the effect of the weight on left ventricular (LV) diastolic function in Asians,who are at greater risk of cardiovascular events compared to individuals from Western countries with similar body mass indices(BMIs). Methods: We studied 543 participants with structurally normal hearts and normal ejection fractions. Participants were classifiedas normal-weight (BMI < 23.0 kg/m2), overweight (BMI 23.0–27.4 kg/m2), or obese (BMI ≥ 27.5 kg/m2). Peak E velocity,peak A velocity, and E’ velocity were measured and E/E’ was calculated. Results: Overweight participants had lower E than normal-weight participants (p = 0.001). E’ velocities in overweight andobese participants were less than those in normal weight participants (both p < 0.001). The E/E’ ratio in obese participants washigher compared to the value in normal-weight participants (p < 0.001) and overweight participants (p = 0.025). BMI was associatedwith E (R = -0.108), A (R = 0.123), E’ (R = -0.229), and E/E’ ratio (R = 0.138) (all p < 0.05). In multivariate analyses,BMI was independently associated with higher A, lower E’, and higher E/E’. The risk of diastolic dysfunction was significantlyhigher among overweight [adjusted odds ratio: 2.088; 95% confidence interval (CI): 1.348–3.235; p = 0.001] and obese participants(adjusted odds ratio: 5.910; 95% CI: 2.871–12.162; p < 0.001) compared to normal-weight participants. Conclusion: Obesity and overweight independently predicted diastolic dysfunction. An optimal body weight lower than theuniversal cut-off is reasonable for preventing LV heart failure in Asians.
참고문헌 (20)
- Russo C, "Effect of obesity and overweight on left ventricular diastolic function: a community-based study in an elderly cohort", J Am Coll Cardiol, 57, pp.1368~1374 (2011)
- Alpert MA, "Obesity cardiomyopathy: pathophysiology and evolution of the clinical syndrome", Am J Med Sci, 321, pp.225~236 (2001)
- Kasper EK, "Cardiomyopathy of obesity: a clinicopathologic evaluation of 43 obese patients with heart failure", Am J Cardiol, 70, pp.921~924 (1992)
- Lyon CJ, "Minireview: adiposity, inflammation, and atherogenesis", Endocrinology, 144, pp.2195~2200 (2003)
- Zhou YT, "Lipotoxic heart disease in obese rats: implications for human obesity", Proc Natl Acad Sci U S A, 97, pp.1784~1789 (2000)
- Chiu HC, "A novel mouse model of lipotoxic cardiomyopathy", J Clin Invest, 107, pp.813~822 (2001)
- Rider OJ, "Effects of catecholamine stress on diastolic function and myocardial energetics in obesity", Circulation, 125, pp.1511~1519 (2012)
- WHO Expert Consultation, "Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies", Lancet, 363, pp.157~163 (2004)
- Lang RM, "American Society of Echocardiography’s Guidelines and Standards Committee; European Association of Echocardiography. Recommendations for chamber quantification: a report from the American Society of Echocardiography’s Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology", J Am Soc Echocardiogr, 18, pp.1440~1463 (2005)
- Devereux RB, "Echocardiographic assessment of left ventricular hypertrophy: comparison to necropsy findings", Am J Cardiol, 57, pp.450~458 (1986)
- Nagueh SF, "Recommendations for the evaluation of left ventricular diastolic function by echocardiography", J Am Soc Echocardiogr, 22, pp.107~133 (2009)
- 배현경, "Cardiovascular Screening in Asymptomatic Adolescents with Metabolic Syndrome", Journal of Cardiovascular Ultrasound, 23(1), pp.10~19 (2015), 한국심초음파학회
- Loehr LR, "Association of multiple anthropometrics of overweight and obesity with incident heart failure: the Atherosclerosis Risk in Communities study", Circ Heart Fail, 2, pp.18~24 (2009)
- Nydia Ávila-Vanzzini, "Excessive Weight and Obesity Are Associated to Intra-Ventricular Asynchrony: Pilot Study", Journal of Cardiovascular Ultrasound, 23(2), pp.86~90 (2015), 한국심초음파학회
- Kossaify A, "Impact of overweight and obesity on left ventricular diastolic function and value of tissue Doppler echocardiography", Clin Med Insights Cardiol, 7, pp.43~50 (2013)
- Deurenberg P, "Asians are different from Caucasians and from each other in their body mass index", body fat per cent relationship, 2002, pp.3, 141~146
- Chang CJ, "Low body mass index but high percent body fat in Taiwanese subjects: implications of obesity cutoffs", Int J Obes Relat Metab Disord, 27, pp.253~259 (2003)
- Oh SW, "Cut-off point of BMI and obesity-related comorbidities and mortality in middle-aged Koreans", Obes Res, 12, pp.2031~2040 (2004)
- Nagueh SF, "Doppler tissue imaging: a noninvasive technique for evaluation of left ventricular relaxation and estimation of filling pressures", J Am Coll Cardiol, 30, pp.1527~1533 (1997)
- Dote K, "Obesity as an independent risk for left ventricular diastolic dysfunction in 692 Japanese patients", Obes Res Clin Pract, 6, pp.e175~e262 (2012)
