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Canadian Journal of Cardiology

Young Women With Abdominal Obesity Have Subclinical Myocardial Dysfunction

Published:February 06, 2015DOI:https://doi.org/10.1016/j.cjca.2015.02.004

      Abstract

      Background

      Abdominal obesity is an independent risk factor for cardiovascular disease. The effect of abdominal obesity on myocardial function in young obese women remains unknown. Therefore, we aimed to investigate cardiac morphology and function, myocardial deformation, and mechanical indices, in young women with and without abdominal obesity.

      Methods

      Cross-sectional analyses of 39 women with abdominal obesity (waist circumference ≥ 80 cm) and 33 nonobese control subjects (waist circumference < 80 cm) aged 18-30 years underwent conventional echocardiographic measures of cardiac morphology and function together with tissue Doppler, and 2-dimensional speckle tracking measures of myocardial deformation and mechanics. Cardiometabolic risk factors including anthropometric, hypertension, biochemistry, and fitness were also assessed.

      Results

      Standard echocardiography results for cardiac morphology and function were similar between groups, with the exception of larger left atrial dimensions in women with abdominal obesity (P ≤ 0.05). Compared with control subjects, women with abdominal obesity also demonstrated reduced systolic and diastolic mitral annular plane velocities, increased left atrial pressure surrogates (E/diastolic mitral annular plane velocity), and prolonged timing measures of diastolic function including isovolumic relaxation time and transmitral deceleration time (P ≤ 0.05). In addition, longitudinal strain and diastolic strain rate were reduced in women with abdominal obesity (P ≤ 0.05) but circumferential deformation and myocardial mechanics (twist indices and rotation) were preserved. Markers of abdominal obesity retained an independent direct correlation with parameters of cardiac dysfunction, explaining 12%-39% of the overall variability.

      Conclusions

      A young, otherwise healthy group of women with abdominal obesity displayed subclinical cardiac dysfunction indicated using selected tissue Doppler imaging and speckle tracking echocardiography measures.

      Résumé

      Introduction

      L’obésité abdominale est un facteur de risque indépendant de la maladie cardiovasculaire. Nous ignorons les conséquences de l’obésité abdominale sur la fonction du myocarde chez les jeunes femmes obèses. Par conséquent, notre but était d’examiner la morphologie et la fonction cardiaque, la déformation du myocarde et les indices mécaniques chez les jeunes femmes souffrant ou non d’obésité abdominale.

      Méthodes

      Les analyses transversales de 39 femmes souffrant d’obésité abdominale (tour de taille ≥ 80 cm) et 33 sujets témoins non obèses (tour de taille < 80 cm) qui étaient âgées de 18 à 30 ans ont subi des mesures échocardiographiques traditionnelles de la morphologie et de la fonction cardiaque par Doppler tissulaire et des mesures par échocardiographie bidimensionnelle Speckle Tracking (suivi de pixel) de la déformation et de la mécanique du cœur. Les facteurs de risque cardiométabolique, y compris l’anthropométrie, l’hypertension, la biochimie et la condition physique ont également été évalués.

      Résultats

      Les résultats de l’échocardiographie standard de la morphologie et de la fonction cardiaque étaient similaires entre les groupes, à l’exception des dimensions plus grandes de l’oreillette gauche chez les femmes souffrant d’obésité abdominale (P ≤ 0,05). Comparativement aux sujets témoins, les femmes souffrant d’obésité abdominale démontraient également une réduction des vitesses systoliques et diastoliques du plan de l’anneau mitral, une augmentation des substituts de la pression auriculaire gauche (E/vitesse diastolique du plan de l’anneau mitral) et des mesures prolongées de la durée de la fonction diastolique, y compris le temps de relaxation isovolumique et du temps de décélération du flux transmitral (P ≤ 0,05). De plus, la déformation longitudinale et le taux de déformation diastolique étaient réduits chez les femmes souffrant d’obésité abdominale (P ≤ 0,05), mais la déformation circonférentielle et la mécanique du myocarde (indices de torsion et rotation) étaient préservées. Les marqueurs de l’obésité abdominale conservaient une corrélation directe indépendante avec les paramètres de la dysfonction cardiaque, ce qui explique 12 % à 39 % de la variabilité globale.

      Conclusions

      Un groupe de femmes jeunes, mais en santé, souffrant d’obésité abdominale montraient une dysfonction sous-clinique cardiaque selon les mesures de l’imagerie Doppler tissulaire et de l’échocardiographie Speckle Tracking (suivi de pixel).
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