Endocrine Abstracts

Aims: Identifying the left ventricular systolic disfunction in obesity is crucial, due to its ability to predict cardiovascular morbidity. LV systolic function is traditionally assessed with the volumetric parameter LV ejection fraction (LVEF). However, normal values for LVEF in all categories of obesity are published in the literature. Furthermore, guidelines for the biomarkers of heart failure, NT-proBNP and BNP, in the obese population remain unclear. Given the restricted BNP and LVEF use, there is a need to use parameters with proven predictability for the occurrence of heart failure in obesity. This research aimed to explore left ventricular systolic function in obese and overweight subjects.

Methods: A total of 126 subjects aged 45,0±9,6 years, were categorized in 4 groups: Group 1 – overweight (BMI 25-29.9 kg/m²); Group 2 – class I obesity (BMI 30-34.9 kg/m²); group 3-class II obesity (BMI 35–39.9 kg/m²) and group 4-class III obesity (BMI >40 kg/m²). The conventional functional parameters of the LV and myocardial deformation by 2D speckel tracking echocardiography were assessed.

Results: In 74 % of the subjects the duration of overweight/obesity was over 10 years. Arterial hypertension, dyslipidemia and diabetes mellitus were present in 54.8%, 53.2%, 19.8% of subjects respectively. The echocardiographic indices of systolic function were preserved: LVEF (67.2%±7.4), indexed cardiac output (37.5±10.3 ml/m2) and indexed minute volume (3.1±2.4 l/min/m2). An average value of the peak mitral annular descend velocity, estimated by Tissue Doppler (s’TDI), was reduced (7.5±1.5 cm/s). The highest classes of obesity had insignificantly lowest values. The mean values of global longitudinal strain (GLS) and global radial strain (GRS) were within reference and mean value of global circumferential strain (GCS) was below the reference range. Subjects with the most severe obesity had the lowest GLS and GCS values (-19.8% and -13.4%, respectively). Significant differences were seen in GLS and GCS between class III and overweight individuals (GLS% P=0.002 and GCS% P=0.033). The GRS% values of the class III obese participants were higher than those of the other groups; nevertheless, no statistically significant differences were found between the groups (P=0.448).

Conclusion: The importance of myocardial deformation assessment is emphasized in context of the identification of subclinical LV dysfunction in obesity