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Article Type

Original Study

Abstract

Background Obesity is associated with heart failure, cardiovascular morbidity, and mortality. A direct effect of weight on left ventricular (LV) structure and myocardial function is not well established. Aim The aim of this study was to determine the effect of isolated obesity on LV morphology and systolic function using LV standard ECG indices and strain imaging indices. Patients and methods Sixty-five individuals were enrolled into this study: 45 with isolated obesity, defined as a BMI of 30 kg/m 2 or higher with no other cardiovascular comorbidities, and 20 nonobese age-adjusted and sex-adjusted controls. All participants underwent standard two-dimensional ECG and myocardial strain imaging. Results There was no significant difference between patients and controls as regards height (P > 0.05). In contrast, weight, BMI, and waist circumference were significantly higher in the patient group compared with the control group (P < 0.001). Obese participants had significantly increased left atrial diameter, aortic diameter, septal wall thickness, LV posterior wall thickness, and LV mass (P < 0.001). There was no significant difference between patients and controls as regards LV diastolic diameter, LV systolic diameter, ejection fraction, fractional shortening, LV mass index, E velocity, A velocity, and the E/A ratio (P > 0.05). Comparative analysis of LV two-dimensional longitudinal strain parameters between patients and controls shows a significant decrease in longitudinal strain in obese patients in the apical long-axis, apical four-chamber, and apical two-chamber views (P < 0.001). Conclusion Obesity is associated with morphologic alterations in the LV, in the form of increased LV mass, interventricular septum thickness, and LV posterior wall thickness, as well as subclinical changes in LV systolic function, which can be detected by strain imaging even without overt heart disease.

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