LEFT VENTRICULAR SYSTOLIC AND DIASTOLIC FUNCTION IN OBESE SUBJECTS : AN ECHO-DOPPLER STUDY
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Thirty asymptomatic normotensive obese subjects, body mass index 03M1) > 30 kg/m2 (14+46.7%) males, 16 (53.3%) females, mean age 32.9 +6.5 years) and 20 well matched healthy lean control subjects (9(45%) males, 11(5596) females, mean age 31.3 + 5.2 years) underwent an echo- Doppler study to evaluate the effects of obesity on systolic as well as on diastolic function. There was no significant difference in heart rate (HR), systolic or diastolic blood pressure (SBP,DBP) between both groups (P=NS). When compared with the lean group, the obese group exhibited a significantly greater end-diastolic diameter (EDD) (4.9+0.2 Vs 4.4+0.3, P<0.01), end diastolic volume (ED'!) (125.5±28 Vs 92.5+27 P<0.01), stroke volume (SW (83.4+19 VS 59.6+17, P<0.01).Cardiac output (CO) (5.9+1.1 VS 4 .1+0.9, P<0.01), left atrial diameter (IA) (3.7+3.1Vs 3.2+2.8,P<0.01), posterior wall thickness (PWT) (1.1+0.7Vs 0.81±0.6, P<0.01) and left ventricular mass index (LVNII)(153+24V594+26, P<0.01). There was no significant difference in end-systolic diameter (ESD), end-systolic volume (ESV), septa' wall thickness (SWT), percentage of fibre shortening (FS) and ejection fraction (EP) between both groups (13:--NS). Pulsed wave Doppler echocardiographic filling indices were used to evaluate left ventricular (LV) diastolic filling. The obese group had a significantly higher peak velocity of atrialfilling (A velocity ) (57 ± 14 Vs 49±13, Pc 0.01), early / atrial filling velocity ratio (E/ A ratio)(1.21 + 0.25 Vs 1.46-1-0.21, P<0.01), time velocity integral of atrial filling velocity (Ai) (4.6±1.7V5 3.2±1.1, P<0.01) and percentage of atrial contribution to total ventricular filling (96AC)(33±6 Vs 24±3,P<0.01). Peak early filling velocity (E- velocity) was insignificantly lower in the obese group than the control group (P-NS), insignificant prolongation of the deceleration time of peak early filling velocity (E-dec.) (P=NS)and insignificantly higher time velocity integral of early filling velocity (Ei) and total time velocity integral (Tvi)(P=NS).Correlation studies revealed that the Bill was significantly correlated with Al and 96 AC (r= 0.62, P<0.05) and (r= 0.48,P<0.01) respectively.