Echocardiographic abnormalities in normotensive obese patients: Relationship with visceral fat

Objective: To evaluate the relationship of echocardiographic characteristics and visceral adipose tissue (VAT) distribution in normotensive obese patients. Research Methods and Procedures: Echocardiographic parameters were assessed in 28 normotensive obese patients [7 men, 21 women, mean age, 43.2 years; mean body mass index (BMI), 37.2 kg/m2; 10 with impaired glucose tolerance (IGT); 6 with type 2 diabetes] and 18 sex-and age-matched healthy, normal-weight controls (4 men, 14 women; mean age, 45.8 years; mean BMI, 22.4 kg/m2) by an M-mode, color-doppler videofluoroscope. VAT in the obese patients was assessed by computed tomography (at L4 level). Results: The obese patients had a significantly larger internal diastolic left ventricular (LV) diameter (p < 0.05), a thicker end-diastolic septum (p < 0.001) and posterior wall (p < 0.001), a greater indexed (g/m2.7) LV mass (p < 0.001), a higher atrial diastolic filling wave velocity (p < 0.001), a lower ratio between early and atrial diastolic filling wave velocities (p < 0.01), and a prolonged isovolumic relaxation time (p < 0.05). End-diastolic septum and posterior wall thickness and the LV mass were significantly greater in patients with a VAT area > 130 cm2 than with <130 cm2. In the multivariate regression analysis, only VAT (p < 0.0001), waist-to-hip ratio (p < 0.001), and sex (p < 0.001) were associated with the most important echocardiographic alterations. Discussion: The morphological and functional echocardiographic alterations usually found in normotensive obese patients closely correlate with the amount of intra-abdominal fat deposition, even in the presence of diabetes or IGT.