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 Effect of visceral obesity on ventricular remodeling


Obesity is known to significantly increase the risk of ventricular remodeling with consequent development of heart failure (HF), although the association between abdominal fat distribution and subclinical ventricular dysfunction has not yet been shown. This study was aimed at identifying the effect of subcutaneous and visceral abdominal obesity on ventricular strain. For this purpose, the study included 340 patients without overt cardiac pathology. All were examined, including laboratory tests, computed tomography of the abdomen and speckle-tracking echocardiography.

Abdominal obesity was quantified as visceral fat area (VFA) and subcutaneous fat area (SFA) at the level of umbilicus. Speckle-tracking echocardiography was performed to assess left ventricular global longitudinal strain (LVGLS) and right ventricular free-wall longitudinal strain (RVLS).

The average age of the study participants was 56 ± 9 years, of which 244 (72%) were men. The mean LVGLS and RVLS were -19.1 ± 3.0% and -25.0 ± 4.1%, respectively.

In addition, both VFA and SFA were correlated with LVGLS (r = 0.46 and r = 0.15, p <0.01) and with RVLS (r = 0.38 and r = 0.12, p <0.05). The most pronounced correlation was between VFA and ventricular strain. It was shown that VFA significantly correlated with LVGLS and RVLS, independent of traditional risk factors for cardiovascular diseases, as well as corresponding laboratory and echocardiographic parameters (p <0.05), whereas SFA was not. Serum adiponectin levels correlated with LVGLS (r = –0.34, p <0.001) and RVLS (r = –0.25, p <0.001), although statistical significance was lost after multivariable adjustment.

Thus, visceral obesity, but not subcutaneous obesity, is significantly associated with decreased both left and right heart ventricles strain, which may increase the risk of heart failure.




European Journal of Preventive Cardiology, December 1, 2020

Volume: 27 issue: 18, page(s): 2006-2015