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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Article info
Publication history
Published online: February 06, 2015
Accepted:
February 4,
2015
Received:
November 6,
2014
Footnotes
See page 1200 for disclosure information.
Identification
Copyright
© 2015 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
