RESUMEN
FUNDAMENTO: A obesidade é um fator de risco independente para as doenças cardiovasculares. Os efeitos da obesidade sobre a estrutura e função do ventriculo esquerdo têm sido relatados, mas, relativamente, pouco se sabe sobre o funcionamento do ventrículo direito (VD) na obesidade. OBJETIVOS: Avaliar as alterações subclínicas do VD em adultos jovens obesos, porém saudáveis, por ecocardiografia convencional e Doppler tecidual (TDI). MÉTODOS: Neste estudo, foram incluídos 35 indivíduos saudáveis de peso normal, com um índice de massa corporal (IMC) < 25 kg/m2 (grupo I), 27 indivíduos com um IMC de 30-34,99 kg/m2 (grupo II) e 42 indivíduos com um IMC > 35 kg/m2 (grupo III). Todos os indivíduos foram submetidos a ecocardiografia transtorácica. Além de medidas ecocardiográficas padrão, as velocidades sistólicas de pico do anel tricúspide (Sm), e as velocidado pico diastólico precoce (Em) e final (Am), tempo de contração isovolumétrica (TCIm), tempo de relaxamento isovolumétrico (TRIm), e o tempo de ejecção (TEm) foram obtidos por TDI e o índice de desempenho do miocárdico do VD (IDMm) foi calculado. RESULTADOS: No grupo II, a razão Em/Am do VD foi significativamente menor e o TRIm e o IDMm foram significativamente maiores em relação ao grupo I (p < 0,01). A Sm, Em, e a razão Em/Am do VD foram significativamente menores e TRIm e IDMm do VD foram significativamente maiores no grupo III em relação ao grupo II (p < 0,05 para Sm e TRIm do VD e p < 0,01 para os outros parâmetros). A Am do VD diferiu significativamente entre os grupos I e III (p < 0,05). O IMC teve uma correlação negativa significante com a Sm, Em, e a razão Em/Am do VD, mas uma correlação positiva com o IDM do VD (p < 0,01). CONCLUSÃO: Nosso estudo mostrou que a obesidade isolada em adultos jovens normotensos foi associada com disfunções subclínicas na estrutura e função do VD.
BACKGROUND: Obesity is an independent risk factor for cardiovascular diseases. The effects of obesity on left ventricular structure and function have been reported, but relatively little is known regarding right ventricular (RV) function in obesity. OBJECTIVE: To evaluate subclinical RV alterations in obese, but otherwise healthy, young adults by conventional echocardiography and tissue Doppler imaging (TDI). METHODS: In this study, we included 35 normal weight healthy subjects with a body mass index (BMI) < 25 kg/m² (group I), 27 subjects with a BMI of 30-34.99 kg/m² (group II), and 42 subjects with a BMI > 35 kg/m² (group III). All subjects underwent transthoracic echocardiography. In addition to standard echocardiographic measurements, tricuspid annular peak systolic (Sm), peak early (Em), and late diastolic (Am) velocities, isovolumetric contraction (ICTm), relaxation (IRTm) time, and ejection time (ETm) were obtained by TDI, and RV myocardial performance index (MPIm) was calculated. RESULTS: In group II, RV Em/Am was significantly decreased and IRTm and MPIm were significantly increased compared to group I (p < 0.01). RV Sm, Em, and the Em/Am ratio were significantly lower and RV IRTm and MPIm were significantly higher in group III than in group II (p < 0.05 for RV Sm and IRTm and p < 0.01 for others). RV Am differed significantly between groups III and I (p < 0.05). BMI was significantly and negatively correlated with RV Sm, Em, and the Em/Am ratio, but positively correlated with RV MPI (p < 0.01). CONCLUSION: Our study showed that isolated obesity in young normotensive adults was associated with subclinical abnormalities in RV structure and function.
Asunto(s)
Adulto , Femenino , Humanos , Masculino , Adulto Joven , Obesidad/complicaciones , Disfunción Ventricular Derecha/etiología , Factores de Edad , Índice de Masa Corporal , Estudios de Casos y Controles , Ecocardiografía Doppler , Obesidad/fisiopatología , Valores de Referencia , Factores de Riesgo , Volumen Sistólico/fisiología , Disfunción Ventricular Derecha/fisiopatologíaRESUMEN
BACKGROUND: Obesity is an independent risk factor for cardiovascular diseases. The effects of obesity on left ventricular structure and function have been reported, but relatively little is known regarding right ventricular (RV) function in obesity. OBJECTIVE: To evaluate subclinical RV alterations in obese, but otherwise healthy, young adults by conventional echocardiography and tissue Doppler imaging (TDI). METHODS: In this study, we included 35 normal weight healthy subjects with a body mass index (BMI) < 25 kg/m² (group I), 27 subjects with a BMI of 30-34.99 kg/m² (group II), and 42 subjects with a BMI > 35 kg/m² (group III). All subjects underwent transthoracic echocardiography. In addition to standard echocardiographic measurements, tricuspid annular peak systolic (Sm), peak early (Em), and late diastolic (Am) velocities, isovolumetric contraction (ICTm), relaxation (IRTm) time, and ejection time (ETm) were obtained by TDI, and RV myocardial performance index (MPIm) was calculated. RESULTS: In group II, RV Em/Am was significantly decreased and IRTm and MPIm were significantly increased compared to group I (p < 0.01). RV Sm, Em, and the Em/Am ratio were significantly lower and RV IRTm and MPIm were significantly higher in group III than in group II (p < 0.05 for RV Sm and IRTm and p < 0.01 for others). RV Am differed significantly between groups III and I (p < 0.05). BMI was significantly and negatively correlated with RV Sm, Em, and the Em/Am ratio, but positively correlated with RV MPI (p < 0.01). CONCLUSION: Our study showed that isolated obesity in young normotensive adults was associated with subclinical abnormalities in RV structure and function.