Research on Cardiac Structure and Function in the Overweight and Obese population and Influence Factors_Journal of Biomedical Engineering

Authors：

ZHANGYanmei ¹ , HANLina ² ,  HUANGHe ¹ , YUYerong ² , LIJiangbo ¹ , LIUXiaoqin ¹

1. Department of Cardiology, West China Hospital, Sichuan University, Chengdu 610041, China;
2. Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu 610041, China;

Corresponding author：

HUANGHe, Email: xhehuang@yahoo.com

Keywords：

body mass index (BMI); three-dimensional speckle tracking imaging (3D-STI); strain; free fatty acid (FFA)

DOI：

10.7507/1001-5515.20160023

Video：

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Abstract Full text Figures/Tables Video References Cited by

In this study we performed Tissue Doppler Imaging (TDI), two-dimensional speckle tracking imaging (2D-STI) and three-dimensional speckle tracking imaging (3D-STI) on enrolled healthy, overweight and obese groups (34 subjects in each group), respectively, to analyze cardiac structure and its function. Compared with healthy group, global longitudinal strain (GLS), global circumferential strain (GCS), global area strain(GAS) and global radial strain (GRS) decreased progressively (P＜0.05). The ratio of early diastolic mitral inflow velocity to global early diastolic strain rate of left ventricle (E/e′sr) (r=0.466, P＜0.001), GLS(r=0.502, P＜0.001), GCS(r=0.426, P＜0.001), GAS(r=0.535, P＜0.001) and GRS(r=-0.554, P＜0.001) were correlated with body mass index (BMI). E/e′sr (r=0.37, P=0.003), GLS(r=0.455, P＜0.001), GCS(r=0.282, P=0.02), GAS(r=0.412, P＜0.001) and GRS (r=-0.471, P＜0.001) were correlated with free fatty acid (FFA). Stepwise multiple linear regression revealed that BMI was independently correlated with E/e′sr, GLS, GCS, GAS and GRS. Waist to hip ratio (WHR) was independently correlated with GLS, GCS, GAS and GRS. FFA was independently correlated with E/e′sr(P＜0.05). The study showed that cardiac structure changed and impaired left ventricular global systolic and diastolic function in overweight and obes population. Moreover, BMI, WHR and FFA may be independent influence factors of cardiac function in overweight and obese population.

Citation： ZHANGYanmei, HANLina, HUANGHe, YUYerong, LIJiangbo, LIUXiaoqin. Research on Cardiac Structure and Function in the Overweight and Obese population and Influence Factors. Journal of Biomedical Engineering, 2016, 331(1): 126-131. doi: 10.7507/1001-5515.20160023 Copy

1.	RUSSO C, JIN Z, HOMMA S, et al. Effect of obesity and overweight on left ventricular diastolic function[J]. J Am Coll Cardiol, 2011, 57(12): 1368-1374.
2.	WANG Q, GAO Y, TAN K, et al. Subclinical impairment of left ventricular function in diabetic patients with or without obesity: A study based on three-dimensional speckle tracking echocardiography[J]. Herz, 2015, 40(Suppl 3): 260-268.
3.	MURPHY N F, MACINTYRE K, STEWART S, et al. Long-term cardiovascular Consequences of obesity: 20-year follow-up of more than 15 000 middle-aged men and women (the Renfrew-Paisley study)[J]. Eur Heart J, 2006, 27(1): 96-106.
4.	MOR-AVI V, LANG R M, BADANO L P, et al. Current and evolving echocardiographic techniques for the quantitative evaluation of cardiac mechanics: ASE/EAE consensus statement on methodology and indications endorsed by the Japanese Society of Echocardiography[J]. Eur J Echocardiogr, 2011, 24(3): 277-313.
5.	中国肥胖问题工作组．中国成人超重和肥胖症预防与控制指南(节录)[J]．营养学报，2004，26（1）：1-4．.
6.	LANG R M, BADANO L P, MOR-AVI V, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging[J]. Eur Heart J Cardiovasc Imaging, 2015, 28(1): 1-39.e14.
7.	JAMES W P. WHO recognition of the global obesity epidemic[J]. Int J Obes (Lond), 2008, 32(Suppl 7): S120-S126.
8.	KENCHAIAH S, EVANS JC, LEVY D, et al. Obesity and the risk of heart failure[J]. N Engl J Med,2002,347(5):305-313.
9.	CUSPIDI C, RESCALDANI M, SALA C, et al. Left-ventricular hypertrophy and obesity: a systematic review and meta-analysis of echocardiographic studies[J]. J Hypertens, 2014, 32(1): 16-25.
10.	KIMURA K, TAKENAKA K, EBIHARA A, et al. Speckle tracking global strain rate E/E′ predicts LV filling pressure more accurately than traditional tissue Doppler E/E′[J]. Echocardiography, 2012, 29(4): 404-410.
11.	CHEN Shi, YUAN Jiansong, QIAO Shubin, et al. Evaluation of left ventricular diastolic function by global strain rate imaging in patients with obstructive hypertrophic cardiomyopathy: a simultaneous speckle tracking echocardiography and cardiac catheterization study[J]. Echocardiography, 2014, 31(5): 615-622.
12.	ERSBLL M, ANDERSEN M J, VALEUR N, et al. Early diastolic strain rate in relation to systolic and diastolic function and prognosis in acute myocardial infarction: a two-dimensional speckle-tracking study[J]. Eur Heart J, 2014, 35(10): 648-656.
13.	CAPUTO M, URSELLI R, ZAC V, et al. Detection of early left ventricular and atrial dysfunction in overweight patients with preserved ejection fraction: a speckle tracking analysis[J]. Echocardiography, 2013, 30(5): 551-557.
14.	BARBOSA J A, MOTA C C, SIMES E SILVA A C, et al. Assessing pre-clinical ventricular dysfunction in obese children and adolescents: the value of speckle tracking imaging[J]. Eur Heart J Cardiovasc Imaging, 2013, 14(9): 882-889.
15.	WIERZBOWSKA-DRABIK K, CHRZANOWSKI L, KAPUSTA A, et al. Severe obesity impairs systolic and diastolic heart function - the significance of pulsed tissue Doppler, strain, and strain rate parameters[J]. Echocardiography, 2013, 30(8): 904-911.
16.	MONTE I P, MANGIAFICO S, BUCCHERI S, et al. Early changes of left ventricular geometry and deformational analysis in obese subjects without cardiovascular risk factors: a three-dimensional and speckle tracking echocardiographic study[J]. Int J Cardiovasc Imaging, 2014, 30(6): 1037-1047.
17.	SALTIJERAL A, ISLA L P, PREZ-RODRGUEZ O, et al. Early myocardial deformation changes associated to isolated obesity: a study based on 3D-wall motion tracking analysis [J]. Obesity (Silver Spring), 2011, 19(11): 2268-2273.
18.	CANOY D. Distribution of body fat and risk of coronary heart disease in men and women[J]. Curr Opin Cardiol, 2008, 23(6): 591-598.
19.	HUXLEY R, MENDIS S, ZHELEZNYAKOV E, et al. Body mass index, waist circumference and waist:hip ratio as predictors of cardiovascular risk--a review of the literature[J]. Eur J Clin Nutr, 2010, 64(1): 16-22.
20.	CHRISTOFFERSEN C, BOLLANO E, LINDEGAARD M L, et al. Cardiac lipid accumulation associated with diastolic dysfunction in obese mice[J]. Endocrinology, 2003, 144(8): 3483-3490.
21.	LEICHMAN J G, AGUILAR D, KING T M, et al. Association of plasma free fatty acids and left ventricular diastolic function in patients with clinically severe obesity[J]. Am J Clin Nutr, 2006, 84(2): 336-341.

1. RUSSO C, JIN Z, HOMMA S, et al. Effect of obesity and overweight on left ventricular diastolic function[J]. J Am Coll Cardiol, 2011, 57(12): 1368-1374.
2. WANG Q, GAO Y, TAN K, et al. Subclinical impairment of left ventricular function in diabetic patients with or without obesity: A study based on three-dimensional speckle tracking echocardiography[J]. Herz, 2015, 40(Suppl 3): 260-268.
3. MURPHY N F, MACINTYRE K, STEWART S, et al. Long-term cardiovascular Consequences of obesity: 20-year follow-up of more than 15 000 middle-aged men and women (the Renfrew-Paisley study)[J]. Eur Heart J, 2006, 27(1): 96-106.
4. MOR-AVI V, LANG R M, BADANO L P, et al. Current and evolving echocardiographic techniques for the quantitative evaluation of cardiac mechanics: ASE/EAE consensus statement on methodology and indications endorsed by the Japanese Society of Echocardiography[J]. Eur J Echocardiogr, 2011, 24(3): 277-313.
5. 中国肥胖问题工作组．中国成人超重和肥胖症预防与控制指南(节录)[J]．营养学报，2004，26（1）：1-4．.
6. LANG R M, BADANO L P, MOR-AVI V, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging[J]. Eur Heart J Cardiovasc Imaging, 2015, 28(1): 1-39.e14.
7. JAMES W P. WHO recognition of the global obesity epidemic[J]. Int J Obes (Lond), 2008, 32(Suppl 7): S120-S126.
8. KENCHAIAH S, EVANS JC, LEVY D, et al. Obesity and the risk of heart failure[J]. N Engl J Med,2002,347(5):305-313.
9. CUSPIDI C, RESCALDANI M, SALA C, et al. Left-ventricular hypertrophy and obesity: a systematic review and meta-analysis of echocardiographic studies[J]. J Hypertens, 2014, 32(1): 16-25.
10. KIMURA K, TAKENAKA K, EBIHARA A, et al. Speckle tracking global strain rate E/E′ predicts LV filling pressure more accurately than traditional tissue Doppler E/E′[J]. Echocardiography, 2012, 29(4): 404-410.
11. CHEN Shi, YUAN Jiansong, QIAO Shubin, et al. Evaluation of left ventricular diastolic function by global strain rate imaging in patients with obstructive hypertrophic cardiomyopathy: a simultaneous speckle tracking echocardiography and cardiac catheterization study[J]. Echocardiography, 2014, 31(5): 615-622.
12. ERSBLL M, ANDERSEN M J, VALEUR N, et al. Early diastolic strain rate in relation to systolic and diastolic function and prognosis in acute myocardial infarction: a two-dimensional speckle-tracking study[J]. Eur Heart J, 2014, 35(10): 648-656.
13. CAPUTO M, URSELLI R, ZAC V, et al. Detection of early left ventricular and atrial dysfunction in overweight patients with preserved ejection fraction: a speckle tracking analysis[J]. Echocardiography, 2013, 30(5): 551-557.
14. BARBOSA J A, MOTA C C, SIMES E SILVA A C, et al. Assessing pre-clinical ventricular dysfunction in obese children and adolescents: the value of speckle tracking imaging[J]. Eur Heart J Cardiovasc Imaging, 2013, 14(9): 882-889.
15. WIERZBOWSKA-DRABIK K, CHRZANOWSKI L, KAPUSTA A, et al. Severe obesity impairs systolic and diastolic heart function - the significance of pulsed tissue Doppler, strain, and strain rate parameters[J]. Echocardiography, 2013, 30(8): 904-911.
16. MONTE I P, MANGIAFICO S, BUCCHERI S, et al. Early changes of left ventricular geometry and deformational analysis in obese subjects without cardiovascular risk factors: a three-dimensional and speckle tracking echocardiographic study[J]. Int J Cardiovasc Imaging, 2014, 30(6): 1037-1047.
17. SALTIJERAL A, ISLA L P, PREZ-RODRGUEZ O, et al. Early myocardial deformation changes associated to isolated obesity: a study based on 3D-wall motion tracking analysis [J]. Obesity (Silver Spring), 2011, 19(11): 2268-2273.
18. CANOY D. Distribution of body fat and risk of coronary heart disease in men and women[J]. Curr Opin Cardiol, 2008, 23(6): 591-598.
19. HUXLEY R, MENDIS S, ZHELEZNYAKOV E, et al. Body mass index, waist circumference and waist:hip ratio as predictors of cardiovascular risk--a review of the literature[J]. Eur J Clin Nutr, 2010, 64(1): 16-22.
20. CHRISTOFFERSEN C, BOLLANO E, LINDEGAARD M L, et al. Cardiac lipid accumulation associated with diastolic dysfunction in obese mice[J]. Endocrinology, 2003, 144(8): 3483-3490.
21. LEICHMAN J G, AGUILAR D, KING T M, et al. Association of plasma free fatty acids and left ventricular diastolic function in patients with clinically severe obesity[J]. Am J Clin Nutr, 2006, 84(2): 336-341.

Journal of Biomedical Engineering

Research on Cardiac Structure and Function in the Overweight and Obese population and Influence Factors

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