Impact of body composition, fat distribution and sustained weight loss on cardiac function in obesity.

• Background Obesity is associated with alterations in left ventricular function varying along with the degree of fatness, but the mechanisms underlying this co-variation are not clear. In a case–control study we examined how sustained weight losses affect cardiac function and report on how body composition and fat distribution relate to the left ventricular performance. Methods At the 10-year follow-up of the Swedish obese subjects (SOS) study cohort we identified 44 patients with sustained weight losses after bariatric surgery (surgery group) and 44 matched obese control patients who remained weight stable (obese group). We also recruited 44 matched normal weight subjects (lean group). Dual-energy X-ray absorptiometry, computed tomography and echocardiography were performed to evaluate body composition, fat distribution and cardiac function. Results BMI was 42.5 kg/m2, 31.5 kg/m2 and 24.4 kg/m2 for the obese, surgery and lean groups respectively. Increasing degree of obesity was associated with larger left ventricular volumes (p < 0.001), higher cardiac output (p < 0.001), reduced systolic myocardial velocity (p < 0.001) and impaired ventricular relaxation (p = 0.015). In multivariate analyses, left ventricular volume, stroke volume and cardiac output primarily associated with lean body mass, whereas blood pressure, heart rate and variables reflecting cardiac dysfunction were more related to total body fat and visceral adiposity. Conclusion Obesity is associated with discrete but distinct disturbances in the left ventricular performance appearing to be related to both the total amount of body fat and degree of visceral adiposity. Patients with sustained weight losses display superior left ventricular systolic and diastolic functions as compared with their obese counterparts remaining weight stable.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kardiologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)

Keyword

Obesity; Weight loss; Body composition; Fat distribution echocardiography; Left ventricular function

Publication and Content Type

ref (subject category)

art (subject category)