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Overweight and obesity impair left ventricular systolic function as measured by left ventricular ejection fraction and global longitudinal strain
Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Biomedical Platform. County Hospital Ryhov, Department of Clinical Physiology, Jönköping, Sweden.
Linköping University, Department of Medical and Health Sciences, Linköping, Sweden.
Futurum, Academy for Health and Care, Jönköping, Sweden.
Linköping University, Department of Internal Medicine and Department of Medical and Health Sciences, Norrköping, Sweden.
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2018 (English)In: Cardiovascular Diabetology, ISSN 1475-2840, E-ISSN 1475-2840, Vol. 17, no 1, article id 113Article in journal (Refereed) Published
Abstract [en]

Aims

Obesity is associated with type 2 diabetes mellitus, left ventricular diastolic dysfunction and heart failure but it is unclear to which extent it is related to left ventricular systolic dysfunction. The aim of the study was to explore the effects of overweight and obesity on left ventricular systolic function in patients with type 2 diabetes mellitus and a control group of non-diabetic persons.

Methods

We prospectively investigated 384 patients with type 2 diabetes mellitus, and 184 controls who participated in the CARDIPP and CAREFUL studies. The participants were grouped according to body mass index (normal weight < 25 kg/m2, overweight 25–29 kg/m2, and obesity ≥ 30 kg/m2). Echocardiography was performed at the beginning of the study and after 4-years in the patient group.

Results

Univariable and multivariable regression analysis revealed that variations in left ventricular ejection fraction, global longitudinal strain, left ventricular mass and diastolic function expressed as E/é (the ratio between early diastolic mitral flow and annular motion velocities) all are related to body mass index. The mean and standard deviation of left ventricular ejection fraction and global longitudinal strain values were 57% (8%) vs. − 18.6% (2.3%) for normal weight patients, 53% (8%) vs. − 17.5% (2.3%) for overweight, and 49% (9%) vs. − 16.2% (3.0%) for obese (p < 0.05 vs. p < 0.05). Corresponding results in the control group were 58% (6%) vs. − 22.3% (3.0%), 55% (7%) vs. − 20.8% (3.1%) and 54% (8%) − 19.6% (4.0%) (p < 0.05 vs. p < 0.05). Patients who gained weight from baseline to follow-up changed left ventricular ejection fraction (median and interquartile range) by − 1.0 (9.0) % (n = 187) and patients who lost weight changed left ventricular ejection fraction by 1.0 (10.0) % (n = 179) (p < 0.05).

Conclusion

Overweight and obesity impair left ventricular ejection fraction and global longitudinal strain in both patients with type 2 diabetes mellitus and non-diabetic persons.

Place, publisher, year, edition, pages
BioMed Central, 2018. Vol. 17, no 1, article id 113
Keywords [en]
Diabetes mellitus, Echocardiography, Obesity, Overweight
National Category
Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:hj:diva-41244DOI: 10.1186/s12933-018-0756-2ISI: 000442121700001PubMedID: 30107798Scopus ID: 2-s2.0-85051543997OAI: oai:DiVA.org:hj-41244DiVA, id: diva2:1241953
Available from: 2018-08-27 Created: 2018-08-27 Last updated: 2019-02-01Bibliographically approved

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Blomstrand, Peter

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