Early Detection of Myocardial Work Impairment in Obesity II(EARLY-MYO-OBESITY-II)

Early Detection of Myocardial Work Impairment in Patients With Overweight and Obesity (EARLY-MYO-OBESITY-II)

This prospective study intends to explore the change of cardiac structure and function in the cohort of overweight or obesity patients, and determine the impact of clinical characteristics on cardiac remodeling and mechanics.

Obesity significantly increases the risk for heart failure. Early detection of preclinical cardiac dysfunction in overweight or obesity and understanding its association with insulin resistance are of great importance.Recently, a novel technique for myocardial work (MW) assessment has been introduced to evaluate myocardial performance. To date, change of MW has been described in several cardiac conditions including dilated cardiomyopathy, significant coronary arterial diseases, and hypertrophic cardiomyopathy, which implies regional or global myocardial dysfunction. In this study, we aimed to explore the alteration of MW in overweight or obese adults and to determine whether insulin resistance or other clinical risk factors may impact myocardial mechanics before impairment of systolic function.

Inclusion Criteria:

• All patients were older than 18 without any cardiac symptoms.
• The diagnosis of overweight was established when body mass index (BMI) of 25 to 30 kg/m2.
• Obese was defined as a BMI of 30 kg/m2 or higher.

Exclusion Criteria:

• diagnosis of type 2-Diabetes Mellitus according to the American Diabetes Association criteria;
• left ventricular ejection fraction<50% on echocardiography;
• arrythmia on electrocardiogram;
• severe valvular stenosis or regurgitation;
• history of coronary disease (defined as stenosis>50%) or myocardial infarction;
• stress induced wall motion abnormality on echocardiography, coronary artery stenosis >50% on coronary CT or angiography with Framingham risk score of >10;
• pacemaker or defibrillator implantation;
• the presence of bundle branch block;
• severe infection or renal dysfunction with an estimated glomerular filtration rate < 60 ml/min/1.73 m2);
• inadequate image quality on echocardiography.