Effect of weight loss on early left atrial myopathy in obese patients without known cardiovascular disease
| Autor: | Rohan S. Wijesurendra, Marco Spartera, Oliver J Rider, Jennifer J Rayner, Barbara Casadei, A Stracquadanio, O Deal, S Neubauer |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Ejection fraction business.industry General Medicine Disease medicine.disease Obesity medicine.anatomical_structure Left atrial Weight loss Internal medicine Heart failure Cardiology Medicine Radiology Nuclear Medicine and imaging Atrium (heart) medicine.symptom Cardiology and Cardiovascular Medicine business Myopathy |
| Zdroj: | European Heart Journal - Cardiovascular Imaging. 22 |
| ISSN: | 2047-2412 2047-2404 |
| DOI: | 10.1093/ehjci/jeab090.053 |
| Popis: | Funding Acknowledgements Type of funding sources: Foundation. Main funding source(s): BHF & NIHR BRC Introduction Obesity is strongly associated with increased risk of heart failure and ischaemic stroke independently of associated co-morbidities. Left atrial (LA) reservoir dysfunction, a marker of atrial distensibility and compliance, is an early pathophysiological change which precedes the onset of cardiovascular disease in patients with obesity. It is unclear whether a weight loss intervention may be sufficient to reverse LA reservoir dysfunction. Purpose To longitudinally assess whether a weight loss intervention normalizes LA reservoir function by cardiac magnetic resonance (CMR) feature-tracking in patients with obesity and only subclinical cardiovascular disease and compared this age and sex matched non-obese normal weight controls. Methods A total of 45 patients with severe obese (age = 45 ± 11 years, body mass index = 39.1 ± 6.7 kg/m2, 51 ± 18 kg of excess body weight [EBW], 67% female) underwent CMR for quantification of LA and left ventricular (LV) size and function before and a median of 373 days following weight loss intervention. Weight loss was achieved by means of a very-low calorie diet (N = 28; 800 kcal/day) or by bariatric surgery (N = 17). A total of N = 27 non-obese healthy controls (age = 41 ± 12 years, body mass index = 22.3 ± 2.4 kg/m2, 75% female) underwent the same CMR protocol once. Results At baseline, patients with obesity displayed signs of atrial myopathy with increased LA volume and reduced LA reservoir function as compared to normal-weight controls (both P 46.6% EBW, in red in Figure 2) was sufficient to improve and normalize the LA reservoir function (P 0.05). Conclusion Successful weight loss can completely revert early LA myopathic phenotype in obese patients without known cardiovascular disease although this can be achieved only with larger weight loss targets. |
| Databáze: | OpenAIRE |
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