Korean Circulation Journal

The Korean Society of Cardiology (대한심장학회)
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Obesity and Preclinical Changes of Cardiac Geometry and Function

Sung, Joong-Kyung;Kim, Jang-Young

  • Published : 20100200
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Abstract

Overweight and obesity are rapidly increasing in prevalence due to adoption of the westernized life style in Korea. Obesity is strongly associated with the development of cardiovascular risk factors such as diabetes, hypertension, and dyslipidemia. In addition, accumulating evidence suggests that obesity per se has a direct effect on cardiac functional and structural changes that may not be the result of atherosclerosis. In this review, we focus on the view that obesity can influence on the structural and functional changes of the heart, drawing evidence from human and animal studies. We also review influencing factors such as physical, neurohormonal, and metabolic alterations that are associated with changes of the heart in obesity.

Keywords

References

  1. Park HS, Park CY, Oh SW, Yoo HJ. Prevalence of obesity and metabolic syndrome in Korean adults. Obes Rev 2008;9:104-7
  2. Kim HM, Park J, Kim HS, Kim DH, Park SH. Obesity and cardiovascular risk factor in Korean children and adolescents aged 10-18 years from the Korean National Health and Nutrition Examination Survey, 1998 and 2001. Am J Epidemiol 2006; 164:787-93 https://doi.org/10.1093/aje/kwj251
  3. Hubert HB, Feinleib M, McNamara PM, Castelli WP. Obesity as an independent risk factor for cardiovascular disease: a 26-year follow-up of participants in the Framingham Heart Study. Circulation 1983;67:968-77 https://doi.org/10.1161/01.CIR.67.5.968
  4. Kenchaiah S, Evans JC, Levy D, et al. Obesity and the risk of heart failure. N Engl J Med 2002;347:305-13 https://doi.org/10.1056/NEJMoa020245
  5. Barouch LA, Berkowitz DE, Harrison RW, O'Donnell CP, Hare JM. Disruption of leptin signaling contributes to cardiac hypertrophy independently of body weight in mice. Circulation 2003; 108:754-9 https://doi.org/10.1161/01.CIR.0000083716.82622.FD
  6. Korvald C, Elvenes OP, Myrmel T. Myocardial substrate metabolism influence left ventricular energetic in vivo. Am J Physiol Heart Circ Physiol 2000;278:H1345-51 https://doi.org/10.1152/ajpheart.2000.278.4.H1345
  7. Ouwens DM, Boer C, Fodor M, et al. Cardiac dysfunction induced by high -fat diet is associated with altered myocardial insulin signaling in rats. Diabetologia 2005;48:1229-37 https://doi.org/10.1007/s00125-005-1755-x
  8. Avelar E, Cloward TV, Walker JM, et al. Left ventricular hypertrophy in severe obesity: interaction among blood pressure, nocturnal hypoxemia, body mass. Hypertension 2007;49:34-9 https://doi.org/10.1161/HYPERTENSIONAHA.107.089862
  9. Wong CY, O'Moore-Sullivan T, Leano R, Byrne N, Beller E, Marwick TH. Alterations of the left ventricular myocardial characteristics associated with obesity. Circulation 2004;110:3081-7 https://doi.org/10.1161/01.CIR.0000147184.13872.0F
  10. Iacobellis G, Ribaudo MC, Zappaterreno A, Iannucci CV, Di Mario U, Leonetti F. Adapted changes in left ventricular struc-ture and function in severe uncomplicated obesity. Obes Res 2004; 12:1616-21 https://doi.org/10.1038/oby.2004.201
  11. Peterson LR, Waggoner AD, Schechtman KB, et al. Alterations in left ventricular structure and function in young healthy obese women: assessment by echocardiography and tissue Doppler imaging. J Am Coll Cardiol 2004;43:1399-404 https://doi.org/10.1016/j.jacc.2003.10.062
  12. Sundstrom J, Lind L, Valind S, et al. Myocardial insulin-mediated glucose uptake and left ventricular geometry. Blood Press 2001;10:27-32
  13. Lauer MS, Anderson KM, Levy D. Separate and joint influence of obesity and mild hypertension on left ventricular mass and geometry: the Framingham Heart Study. J Am Coll Cardiol 1992;19: 130-4 https://doi.org/10.1016/0735-1097(92)90063-S
  14. Gottdiener JS, Reda DJ, Materson BJ, et al. Importance of obesity, race and age to the cardiac structure and functional effect of hypertension. J Am Coll Cardiol 1994;24:1492-8 https://doi.org/10.1016/0735-1097(94)90145-7
  15. Fox E, Taylor H, Andrew M, et al. Body mass index and blood pressure influence on left ventricular mass and geometry in African Americans: the Atherosclerotic Risk In Communities (ARIC) Study Hypertension 2004;44:55-60 https://doi.org/10.1161/01.HYP.0000132373.26489.58
  16. Iacobellis G, Leonetti F. Epicardial adipose tissue and insulin resistance in obese subjects. J Clin Endocardiol Metab 2005;90: 6300-2 https://doi.org/10.1210/jc.2005-1087
  17. Iacobellis G, Ribaudo MC, Zappaterreno A, Iannucci CV, Leonetti F. Relation between epicardial adipose tissue and left ventricular mass. Am J Cardiol 2004;94:1084 -7 https://doi.org/10.1016/j.amjcard.2004.06.075
  18. Corradi D, Maestri R, Callegari S, et al. The ventricular epicardial fat is related to the myocardial mass in normal, ischemic and hypertrophic hearts. Cardiovasc Pathol 2004;13:313-6 https://doi.org/10.1016/j.carpath.2004.08.005
  19. Malavazos AE, Ermetici F, Coman C, Corsi MM, Morricone L, Ambrosi B. Influence of epicardial adipose tissue and adipocytokine levels on cardiac abnormalities in visceral obesity. Int J Cardiol 2007;121:132-4 https://doi.org/10.1016/j.ijcard.2006.08.061
  20. Ayer JG, Almafragy HS, Patel AA, Hellyer RL, Celermajer DS. Body mass index is an independent determinant of left atrial size. Heart Lung Circ 2008;17:19-24 https://doi.org/10.1016/j.hlc.2007.04.006
  21. Di Bello V, Santini F, Di Cori A, et al. Obesity cardiomyopathy: is it a reality? An ultrasonic tissue characterization study. J Am Soc Echocardiogr 2006;19:1063-71 https://doi.org/10.1016/j.echo.2006.03.033
  22. Pritchett AM, Mahoney DW, Jacobsen SJ, Rodeheffer RJ, Karon BL, Redfield MM. Diastolic dysfunction and left atrial volume: a population-based study. J Am Coll Cardiol 2005;45:87-92 https://doi.org/10.1016/j.jacc.2004.09.054
  23. Wang TJ, Parise H, Levy D, et al. Obesity and the risk of newonset atrial fibrillation. JAMA 2004;292:2471-7 https://doi.org/10.1001/jama.292.20.2471
  24. Tsang TS, Barnes ME, Miyasaka Y, et al. Obesity as a risk factor for the pregression of paroxysmal to permanent atrial fibrillation: a longitudinal cohort study of 21 years. Eur Heart J 2008;29: 2227-33 https://doi.org/10.1093/eurheartj/ehn324
  25. Messerli FH, Ventura HO, Reisin E, et al. Borderline hypertension and obesity: two prehypertensive states with elevated cardiac output. Circulation 1982;66:55-60 https://doi.org/10.1161/01.CIR.66.1.55
  26. Aurigemma GP, Silver KH, Priest MA, Gaasch WH. Geometric changes allow normal ejection fraction despite depressed myocardial myocardial shortening in hypertensive left ventricular hypertrophy. J Am Coll Cardiol 1995;26:195-202 https://doi.org/10.1016/0735-1097(95)00153-Q
  27. Garavaglia GE, Messerli FH, Nunez BD, Schmieder RE, Grossman E. Myocardial contractility and left ventricular function in obese patients with essential hypertension. Am J Cardiol 1988; 62:594-7 https://doi.org/10.1016/0002-9149(88)90662-5
  28. Aasum E, Hafstad AD, Severson DL, Larsen TS. Age-dependent changes in metabolism, contractile function, and ischemic sensitivity in hearts from db/db mice. Diabetes 2003;52:434-41 https://doi.org/10.2337/diabetes.52.2.434
  29. Peterson LR, Herrero P, Schechtman KB, et al. Effect of obesity and insulin resistance on myocardial substrate metabolism and efficiency in young women. Circulation 2004;109:2191-6 https://doi.org/10.1161/01.CIR.0000127959.28627.F8
  30. Pascual M, Pascual DA, Soria F, et al. Effect of isolated obesity on systolic and diastolic left ventricular function. Heart 2003; 89:1152-6 https://doi.org/10.1136/heart.89.10.1152
  31. Berkalp B, Cesur V, Corapcioglu D, Erol C, Baskal N. Obesity and left ventricular diastolic dysfunction. Int J Cardiol 1995;52: 23-6 https://doi.org/10.1016/0167-5273(95)02431-U
  32. Morricone L, Malavazos AE, Coman C, Donati C, Hassen T, Caviezel F. Echocardiographic abnormalities in normotensive obese patients: relationship with visceral fat. Obes Res 2002;10: 489-98 https://doi.org/10.1038/oby.2002.67
  33. Chakko S, Mayor M, Allison MD, Kessler KM, Materson BJ, Myerburg RJ. Abnormal left ventricular diastolic filling in eccentric left ventricular hypertrophy of obesity. Am J Cardiol 1991; 68:95-8 https://doi.org/10.1016/0002-9149(91)90718-Z
  34. Christoffersen C, Bollano E, Lindegaard ML, et al. Cardiac lipid accumulation associated with diastolic dysfunction in obese mice. Endocrinology 2003;144:3483-90 https://doi.org/10.1210/en.2003-0242
  35. Kozakova M, Muscelli E, Flyvbjerg A, et al. Adiponectin and left ventricular structure and function in healthy adults. J Clin Endocrinol Metab 2008;93:2811-8 https://doi.org/10.1210/jc.2007-2580
  36. Mizushige K, Yao L, Noma T, et al. Alteration in left ventricular diastolic filling and accumulation of myocardial collagen at insulin-resistant prediabetic stage of a type II diabetic rat model. Circulation 2000;101:899-907 https://doi.org/10.1161/01.CIR.101.8.899
  37. Messerli FH, Christie B, DeCarvalho JGR, et al. Obesity and essential hypertension; hemodynamics, intravascular volume, sodium excretion, and plasma renin activity. Arch Intern Med 1981; 141:81-5 https://doi.org/10.1001/archinte.141.1.81
  38. Must A, Spadano J, Coakley EH, Field AE, Colditz G, Dietz WH. The disease burden associated with overweight and obesity. JAMA 1999;282:1523-9 https://doi.org/10.1001/jama.282.16.1523
  39. Peppard PE, Young T, Palta M, Skatrud J. Prospective study of the association between sleep-disordered breathing and hypertension. N Engl J Med 2000;342:1378-84 https://doi.org/10.1056/NEJM200005113421901
  40. Quan SF, Gersh BJ. Cardiovascular consequences of sleepdisordered breathing: past, present and future: report of a workshop from the National Center on Sleep Disorders Research and the National Heart, Lung, Blood Institute. Circulation 2004;109: 951-7 https://doi.org/10.1161/01.CIR.0000118216.84358.22
  41. Cloward TV, Walker JM, Farney RJ, Anderson JL. Left ventricular hypertrophy is a common echocardiographic abnormality in severe obstructive sleep apnea and reverses with nasal continuous positive airway pressure. Chest 2003;124:594-601 https://doi.org/10.1378/chest.124.2.594
  42. Buchanan J, Mazumder PK, Hu P, et al. Reduced cardiac efficiency and altered substrate metabolism precedes the onset of hyperglycemia and contractile dysfunction in two mouse models of insulin resistance and obesity. Endocrinology 2005;146:5341-9 https://doi.org/10.1210/en.2005-0938
  43. Mazumder PK, O'Neill BT, Roberts MW, et al. Impaired cardiac efficiency and increased fatty acid oxidation in insulin-resistant ob/ob mouse hearts. Diabetes 2004;53:2366-74 https://doi.org/10.2337/diabetes.53.9.2366
  44. Coort SL, Hasselbaink DM, Koonen DP, et al. Enhanced sarcolemmal FAT/CD 36 content and triacylglycerol storage in cardiac myocytes from obese zucker rats. Diabetes 2004;53:1655-63 https://doi.org/10.2337/diabetes.53.7.1655
  45. Semeniuk LM, Kryski AJ, Severson DL. Echocardiographic assessment of cardiac function in diabetic db/db and transgenic db/db-hGLUT4 mice. Am J Physiol Heart Circ Physiol 2002;283: H976-82 https://doi.org/10.1152/ajpheart.00088.2002
  46. Boudina S, Sena S, Theobald H, et al. Mitochondrial energetics in the heart in obesity related diabetes: direct evidence for increased uncoupled respiration and activation of uncoupling proteins. Diabetes 2007;56:2457-66 https://doi.org/10.2337/db07-0481
  47. Unger RH. Lipotoxic disease. Annu Rev Med 2002;53:319-36 https://doi.org/10.1146/annurev.med.53.082901.104057
  48. Zhou YT, Grayburn P, Karim A, et al. Lipotoxic heart disease in obese rats: implications for human obesity. Proc Natl Acad Sci U S A 2000;97:1784-9 https://doi.org/10.1073/pnas.97.4.1784
  49. Sidell RJ, Cole MA, Draper NJ, Desrois M, Buckingham RE, Clarke K. Thiazolidinedione treatment normalizes insulin resistance and ischemic injury in the Zucker fatty rat heart. Diabetes 2002;51:1110-7 https://doi.org/10.2337/diabetes.51.4.1110
  50. Ruano M, Silvestre V, Castro R, et al. Morbid obesity, hypertensive disease and the rennin-angiotensin-aldosterone axis. Obes Surg 2005;15:670-6 https://doi.org/10.1381/0960892053923734
  51. Hainault I, Nebout G, Turban S, Ardouin B, Ferre P, Quiqnard-Boulange A. Adipose tissue-specific increase in angiotensinogen expression and secretion in the obese (fa/fa) Zucker rat. Am J Physiol Endocrinol Metab 2002;282:E59-66
  52. Davy KP, Hall JE. Obesity and hypertension: two epidemics or one? Am J Physiol Regul Integr Comp Physiol 2004;286:R803-13 https://doi.org/10.1152/ajpregu.00707.2003
  53. Miner EC, Miller WL. A look between the cardiomyocytes: the extracellular matrix in heart failure. Mayo Clin Proc 2006;81: 71-6 https://doi.org/10.4065/81.1.71
  54. Quilliot D, Alla F, Bohme P, et al. Myocardial collagen turnover in normotensive obese patients: relation to insulin resistance. Int J Obes 2005;29:1321-8 https://doi.org/10.1038/sj.ijo.0803022
  55. Carroll JF, Tyagi SC. Extracellular matrix remodeling in the heart of the homocysteinemic obese rabbit. Am J Hypertens 2005; 18:692-8 https://doi.org/10.1016/j.amjhyper.2004.11.035
  56. Halaas JL, Gajiwala KS, Maffei M, et al. Weight-reducing effects of the plasma protein encoded by the obese gene. Science 1995; 269:543-6 https://doi.org/10.1126/science.7624777
  57. Madani S, De Girolamo S, Munoz DM, Li RK, Sweeney G. Direct effects of leptin on size and extracellular matrix components of human pediatric ventricular myocytes. Cardiovasc Res 2006;69:716-25 https://doi.org/10.1016/j.cardiores.2005.11.022
  58. Park S, Cho YR, Kim HJ, et al. Unraveling the temporal pattern of diet-induced insulin resistance in individual organs and cardiac dysfunction in C57BL/6 mice. Diabetes 2005;54:3530-40 https://doi.org/10.2337/diabetes.54.12.3530
  59. Purdham D, Zou MX, Rajapurohitam V, Karmazyn M. Rat heart is a site of leptin production and action. Am J Physiol Heart Circ Physiol 2004;287:H2877-84 https://doi.org/10.1152/ajpheart.00499.2004
  60. Kumada M, Kihara S, Ouchi N, et al. Adiponectin specifically increased TIMP-1 through interleukin-10 expression in human macrophages. Circulation 2004;109:2046-9 https://doi.org/10.1161/01.CIR.0000127953.98131.ED
  61. Olivetti G, Abbi R, Quaini F, et al. Apoptosis in the failing human heart. N Engl J Med 1997;336:1131-41 https://doi.org/10.1056/NEJM199704173361603
  62. Communal C, Sumandea M, de Tombe P, Narula J, Solaro RJ, Hajjar RJ. Functional consequences of caspase activation in cardiac myocytes. Proc Natl Acad Sci U S A 2002;99:6252-6 https://doi.org/10.1073/pnas.092022999
  63. Cigola E, Kajstura J, Li B, Meggs LG, Anversa P. Angiotensin II activates programmed myocyte cell death in vitro. Exp Cell Res 1997;231:363-71 https://doi.org/10.1006/excr.1997.3477
  64. Communal C, Singh K, Sawyer DB, Colucci WS. Opposing effects of beta 1- and beta2- adrenergic receptors on cardiac myocyte apoptosis: role of a pertussis-toxin sensitive G protein. Circulation 1999;100:2210-2 https://doi.org/10.1161/01.CIR.100.22.2210
  65. Relling DP, Esberg LB, Fang CX, et al. High-fat diet-induced juvenile obesity leads to cardiomyocyte dysfunction and upregulation of Foxo3a transcription factor independent of lipotoxicity and apoptosis. J Hypertens 2006;24:549-61 https://doi.org/10.1097/01.hjh.0000203846.34314.94
  66. Alpert MA, Lambert CR, Panayiotou H, et al. Relation of duration of morbid obesity to left ventricular mass, systolic function, and diastolic filling, and effect of weight loss. Am J Cardiol 1995; 76:1194-7 https://doi.org/10.1016/S0002-9149(99)80338-5
  67. Klein S, Fontana L, Young VL, et al. Absence of an effect of liposuction on insulin action and risk factors for coronary heart disease. N Engl J Med 2004;350:2549-57 https://doi.org/10.1056/NEJMoa033179
  68. Torgerson JS, Hauptman J, Boldrin MN, Sjostrom L. Xenical in the prevention of diabetes in obese subjects (XENDOS) study. Diabetes Care 2004;27:155-61 https://doi.org/10.2337/diacare.27.1.155
  69. Wadden TA, Berkowitz RI, Womble LG, et al. Randomised trial of lifestyle modification and pharmacotherapy for obesity. N Engl J Med 2005;353:2111-20 https://doi.org/10.1056/NEJMoa050156
  70. Curioni C, Andre C. Rimonabant for overweight or obesity. Cochrane Database Syst Rev 2006;4:CD006162
  71. Padwal RS, Majumdar SR. Drug treatments for obesity: oristat, sibutramine, and rimonabant. Lancet 2007;369:71-7 https://doi.org/10.1016/S0140-6736(07)60033-6

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