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The Role of Echocardiography in the Evaluation of Cardiac Damage in Hypertensive Obese Patient

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Abstract

Obesity rates are rising worldwide. Often obesity is associated with hypertension leading to an increased cardiovascular risk. Both obesity and hypertension induce several modifications in cardiac structure and function, particularly atrial and ventricular remodeling is a common finding shared by these two conditions. It has been demonstrated obesity leads to: left ventricular (LV) mass increase, LV systolic and diastolic dysfunction, left atrium (LA) size increase, LA function alterations and pericardial fat accumulation. Nowadays, the development of cardiac imaging techniques allows to early identifying any preclinical damage related to hypertension and obesity. This could be very important in order to improve patient management and medical therapy.

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References

  1. de Simone G, Devereux RB, Mureddu GF, Roman MJ, Ganau A, Alderman MH, Contaldo F, Laragh JH. Influence of obesity on left ventricular midwall mechanics in arterial hypertension. Hypertension. 1996;28:276–83.

    Article  PubMed  Google Scholar 

  2. Kotsis V, Stabouli S, Papakatsika S, Rizos Z, Parati G. Mechanisms of obesity-induced hypertension. Hypertens Res. 2010;33(5):386–93.

    Article  PubMed  Google Scholar 

  3. Wolk R, Shamsuzzaman AS, Somers VK. Obesity, sleep apnea, and hypertension. Hypertension. 2003;42(6):1067–74.

    Article  CAS  PubMed  Google Scholar 

  4. Lauer MS, Anderson KM, Kannel WB, Levy D. The impact of obesity on left ventricular mass and geometry. The Framingham Heart Study. JAMA. 1991;266:231–6.

    Article  CAS  PubMed  Google Scholar 

  5. de Simone G, Devereux RB, Roman MJ, Alderman MH, Laragh JH. Relation of obesity to left ventricular hypertrophy in normotensive and hypertensive adults. Hypertension. 1994;23:600–6.

    Article  PubMed  Google Scholar 

  6. Avelar E, Cloward TV, Walker JM, Farney RJ, Strong M, Pendleton RC, Segerson N, Adams TD, Gress RE, Hunt SC, Litwin SE. Left ventricular hypertrophy in severe obesity: interactions among blood pressure, nocturnal hypoxemia, and body mass. Hypertension. 2007;49(1):34–9.

    Article  CAS  PubMed  Google Scholar 

  7. Cuspidi C, Rescaldani M, Sala C, Grassi G. Left ventricular hypertrophy and obesity : a systematic review and meta-analysis of echocardiographic studies. J Hypertens. 2014;32:16–25.

    Article  CAS  PubMed  Google Scholar 

  8. Aurigemma GP, de Simone G, Fitzgibbons TP. Cardiac remodeling in obesity. Circ Cardiovasc Imaging. 2013;6(1):142–52.

    Article  PubMed  Google Scholar 

  9. Antonini-Canterin F, Mateescu AD, Vriz O, La Carrubba S, Di Bello V, Carerj S, Zito C, Sparacino L, Marzano B, Usurelu C, Ticulescu R, Ginghină C, Nicolosi GL, Popescu BA. Cardiac structure and function and insulin resistance in morbidly obese patients: does superobesity play an additional role? Cardiology. 2013;127(3):144–51.

    PubMed  Google Scholar 

  10. Messerli FH, Sundgaard-Riise K, Reisin ED, Dreslinski GR, Ventura HO, Oigman W, Frohlich ED, Dunn FG. Dimorphic cardiac adaptation to obesity and arterial hypertension. Am Intern Med. 1983;99:757–61.

    Article  CAS  Google Scholar 

  11. Khouri MG, Peshock RM, Ayers CR, de Lemos JA, Drazner MH. A 4-tiered classification of left ventricular hypertrophy based on left ventricular geometry: the Dallas heart study. Circ Cardiovasc Imaging. 2010;3(2):164–71.

    Article  PubMed  Google Scholar 

  12. Pacileo G, Castaldi B, Di Salvo G, Limongelli G, Rea A, D’Andrea A, Russo MG, Calabrò R. Assessment of left-ventricular mass and remodeling in obese adolescents: M-mode, 2D or 3D echocardiography? J Cardiovasc Med (Hagerstown). 2013;14(2):144–9.

    Article  Google Scholar 

  13. Powell BD, Redfield MM, Bybee KA, Freeman WK, Rihal CS. Association of obesity with left ventricular remodeling and diastolic dysfunction in patients without coronary artery disease. Am J Cardiol. 2006;98(1):116–20.

    Article  PubMed  Google Scholar 

  14. Peterson LR, Waggoner AD, Schechtman KB, Meyer T, Gropler RJ, Barzilai B, Dávila-Román VG. Alterations in left ventricular structure and function in young healthy obese women: assessment by echocardiography and tissue Doppler imaging. J Am Coll Cardiol. 2004;43(8):1399–404.

    Article  PubMed  Google Scholar 

  15. Cusmà Piccione M, Piraino B, Zito C, Khandheria BK, Di Bella G, De Gregorio C, Oreto L, Rigoli L, Ferraù V, Salpietro CD, Carerj S. Early identification of cardiovascular involvement in patients with β-thalassemia major. Am J Cardiol. 2013;112(8):1246–51.

    Article  PubMed  Google Scholar 

  16. Cusmà Piccione M, Zito C, Bagnato G, Oreto G, Di Bella G, Bagnato G, Carerj S. Role of 2D strain in the early identification of left ventricular dysfunction and in the risk stratification of systemic sclerosis patients. Cardiovasc Ultrasound. 2013;11:6.

    Article  PubMed Central  PubMed  Google Scholar 

  17. Di Salvo G, Di Bello V, Salustri A, Antonini-Canterin F, La Carrubba S, Materazzo C, Badano L, Caso P, Pezzano A, Calabrò R, Carerj S. Research Group of the Italian Society of Cardiovascular Echography. The prognostic value of early left ventricular longitudinal systolic dysfunction in asymptomatic subjects with cardiovascular risk factors. Clin Cardiol. 2011;34(8):500–6.

    Article  PubMed  Google Scholar 

  18. Imbalzano E, Zito C, Carerj S, Oreto G, Mandraffino G, Cusmà-Piccione M, Di Bella G, Saitta C, Saitta A. Left ventricular function in hypertension: new insight by speckle tracking echocardiography. Echocardiography. 2011;28(6):649–57.

    Article  PubMed  Google Scholar 

  19. Orhan AL, Uslu N, Dayi SU, Nurkalem Z, Uzun F, Erer HB, Hasdemir H, Emre A, Karakus G, Soran O, Gorcsan J 3rd, Eren M. Effects of isolated obesity on left and right ventricular function: a tissue Doppler and strain rate imaging study. Echocardiography. 2010;27(3):236–43.

    Article  PubMed  Google Scholar 

  20. Zito C, Mohammed M, Todaro MC, Khandheria BK, Cusmà-Piccione M, Oreto G, Pugliatti P, Abusalima M, Antonini-Canterin F, Vriz O, Carerj S. Interplay between arterial stiffness and diastolic function: a marker of ventricular-vascular coupling. J Cardiovasc Med. 2014; [Epub ahead of print].

  21. Tavares Ida S, Sousa AC, Menezesilho RS, Aguiar-Oliveira MH, Barreto-Filho JA, Brito AF, Oliveira JL. Left ventricular diastolic function in morbidly obese patients in the preoperative for bariatric surgery. Arq Bras Cardiol. 2012;98(4):300–6.

    Article  PubMed  Google Scholar 

  22. Rocha IEGM, Victor EG, Braga MC, Silva OB, Becker MMC. Avaliação ecocardiográfica em obesos graves assintomáticos. Arq Bras Cardiol. 2007;88(1):52–8.

    Article  PubMed  Google Scholar 

  23. Boyer JK, Thanigaraj S, Schechtman KB, Perez JE. Prevalence of ventricular diastolic dysfunction in asymptomatic, normotensive patients with diabetes mellitus. Am J Cardiol. 2004;93(7):870–5.

    Article  PubMed  Google Scholar 

  24. Russo C, Jin Z, Homma S, Rundek T, Elkind MS, Di Sacco RL, Tullio MR. Effect of obesity and overweight on left ventricular diastolic function: a community-based study in an elderly cohort. J Am Coll Cardiol. 2011;57(12):1368–74.

    Article  PubMed Central  PubMed  Google Scholar 

  25. Trivedi PS, Barouch LA. Cardiomyocyte apoptosis in animal models of obesity. Curr Hypertens Rep. 2008;10(6):454–60.

    Article  CAS  PubMed  Google Scholar 

  26. Cameli M, Lisi M, Righini FM, Mondillo S. Novel echocardiographic techniques to assess left atrial size, anatomy and function. Cardiovasc Ultrasound. 2012;1(10):4.

    Article  Google Scholar 

  27. Gottdiener JS, Reda DJ, Williams DW, Materson BJ. Left atrial size in hypertensive men: influence of obesity, race and age. Department of Veterans Affairs Cooperative Study Group on Antihypertensive Agents. J Am Coll Cardiol. 1997;29(3):651–8.

    Article  CAS  PubMed  Google Scholar 

  28. Todaro MC, Choudhuri I, Belohlavek M, Jahangir A, Carerj S, Oreto L, Khandheria BK. New echocardiographic techniques for evaluation of left atrial mechanics. Eur Heart J Cardiovasc Imaging. 2012;13(12):973–84.

    Article  PubMed Central  PubMed  Google Scholar 

  29. Longobardo L, Todaro MC, Zito C, Piccione MC, Di Bella G, Oreto L, Khandheria BK, Carerj S. Role of imaging in assessment of atrial fibrosis in patients with atrial fibrillation: state-of-the-art review. Eur Heart J Cardiovasc Imaging. 2014;15(1):1–5.

  30. Kokubu N, Yuda S, Tsuchihashi K, Hashimoto A, Nakata T, Miura T, Ura N, Nagao K, Tsuzuki M, Wakabayashi C, Shimamoto K. Noninvasive assessment of left atrial function by strain rate imaging in patients with hypertension: a possible beneficial effect of renin-angiotensin system inhibition on left atrial function. Hypertens Res. 2007;30(1):13–21.

    Article  PubMed  Google Scholar 

  31. Konishi M, Sugiyama S, Sugamura K, Nozaki T, Matsubara J, Akiyama E, Utsunomiya D, Matsuzawa Y, Yamashita Y, Kimura K, Umemura S, Ogawa H. Accumulation of pericardial fat correlates with left ventricular diastolic dysfunction in patients with normal ejection fraction. J Cardiol. 2012;59(3):344–51.

    Article  PubMed  Google Scholar 

  32. Vest AR, Heneghan HM, Agarwal S, Schauer PR, Young JB. Bariatric surgery and cardiovascular outcomes: a systematic review. Heart. 2012;98:1763–77.

    Article  PubMed  Google Scholar 

  33. Cavarretta E, Casella G, Calì B, Dammaro C, Biondi-Zoccai G, Iossa A, Leonetti F, Frati G, Basso N. Cardiac remodeling in obese patients after laparoscopic sleeve gastrectomy. World J Surg. 2013;37(3):565–72.

    Article  PubMed  Google Scholar 

  34. Cuspidi C, Rescaldani M, Tadic M, Sala C, Grassi G. Effects of bariatric surgery on cardiac structure and function: a systematic review and meta-analysis. Am J Hypertens. 2014;27(2):146–56.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy

    P. Crea, C. Zito, M. Cusmà Piccione, S. Arcidiaco, M. C. Todaro, L. Oreto & S. Carerj

  2. Department of Human Pathology, University of Messina, Messina, Italy

    G. Navarra

Authors
  1. P. Crea
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  2. C. Zito
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  3. M. Cusmà Piccione
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  4. S. Arcidiaco
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  5. M. C. Todaro
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  6. L. Oreto
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  7. G. Navarra
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  8. S. Carerj
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Correspondence to P. Crea.

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Crea, P., Zito, C., Cusmà Piccione, M. et al. The Role of Echocardiography in the Evaluation of Cardiac Damage in Hypertensive Obese Patient. High Blood Press Cardiovasc Prev 22, 23–27 (2015). https://doi.org/10.1007/s40292-014-0058-z

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  • DOI: https://doi.org/10.1007/s40292-014-0058-z

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