Left Ventricular Remodeling Predictors in Patients with Obesity of Varying Severity

The purpose of the study was to examine clinical and anthropometric predictors of left ventricular hypertrophy in patients with isolated obesity of different stages of severity. Materials and methods. 63 people with obesity and overweight, who formed the main group, were examined. The control group included 22 people with normal weight. All participants of the study were subjected to a general clinical examination with a mandatory measurement of the waist and hip circumference, weight and height, transthoracic echocardiography. The calculations were performed using SPSS software (version 22.0; SPSS, Chicago, IL). Results. It was found out that systolic function in all subjects was normal and did not significantly differ from the control group. Patients with severe obesity significantly higher thickness of interventricular septum, thickness of the posterior wall of the left ventricle, left ventricular mass index (g/m2) and left ventricular mass index (g/PPTm2). Left ventricular hypertrophy was established only in 3 patients from group with severe obesity. All patients had a concentric remodeling of left ventricular. There were no significant differences in patients with high body weight. It was estimated that patients with abdominal obesity in comparison with the group of patients with other types of obesity had significantly higher thickness of the posterior wall of the left ventricle ((0,95 ± 0,11) cm versus (0,83 ± 0,10) cm), thickness of interventricular septum ((0,89 ± 0,12) cm vs. (0,72 ± 0,1)) and left ventricular mass index ((82,13 ± 7,12) g / PPTm2 vs. (79,6 ± 8,12) g / PPTm2). According to correlation analysis results, a positive correlation was found between BMI and thickness of the posterior wall of the left ventricle (r = 0,422, p = 0,05), thickness of interventricular septum (r = 0,38, p = 0,001) and left ventricular mass index (m2/PPT) (r = 0,384, p < 0,05). Weak positive correlation between waist circumference and left ventricular mass index was established (m2 / PPT) (r = 0,211, p = 0,03). Based on the literature data, potential predictors of the increase of left ventricular mass and left ventricular mass index (g/PPTm2) were selected: among the anamnestic factors – age; among clinical factors – average systolic arterial pressure, among anthropometric factors – weight, BMI, waist circumference, circle hips, waist circumference/circle hips ratio. These variables were tested in a multi-factor regression model. The final regression model demonstrated that the age and waist circumference/circle hips ratio were an independent predictor of changes in left ventricular mass index (g/m2) and left ventricular mass index (g/PPTm2) in obese patients without cardiovascular disease. Conclusions. Reliable structural and functional changes of the left ventricle in patients with isolated moderate and severe obesity were established. Left ventricular hypertrophy was diagnosed only in 3 patients with the third degree of obesity. All of them had a concentric remodeling of the myocardium. According to regression analysis, the age and waist circumference/circle hips ratio were independent predictors of changes in left ventricular mass index (g/m2) and left ventricular mass index (g/PPTm2) in obese patients without cardiovascular disease.