Decreased left atrial function in obesity patients without known cardiovascular disease

Y. S. Aga, D. Kroon, S. M. Snelder, L. U. Biter, L. E. de Groot-de Laat, F. Zijlstra, J. J. Brugts, Bas M. van Dalen*

*Corresponding author for this work

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Abstract

Obesity is a risk factor for heart failure with preserved ejection fraction (HFpEF). We hypothesized that assessment of left atrial (LA) strain may be useful to reveal precursors of HFpEF in obesity patients. Echocardiograms of obesity patients without known cardiovascular disease who underwent bariatric surgery, and echocardiograms of age- and gender matched controls were analyzed. The echocardiogram was repeated 1 year after bariatric surgery. LA reservoir strain (LASr), LA conduit strain (LAScd), and LA contractile strain (LASct) were measured. 77 Obesity patients were compared with 46 non-obese controls. Obesity patients showed a significantly decreased LA function compared with non-obese individuals (LASr 32.2% ± 8.8% vs. 39.6% ± 10.8%, p < 0.001; LAScd 20.1% ± 7.5% vs. 24.9% ± 8.3%, p = 0.001; LASct 12.1% ± 3.6% vs. 14.5% ± 5.5%, p = 0.005). There was no difference in prevalence of diastolic dysfunction between the obesity group and controls (9.1% vs. 2.2%, p = 0.139). One year after bariatric surgery, LASr improved (32.1% ± 8.9% vs. 34.2% ± 8.7%, p = 0.048). In the multivariable linear regression analysis, BMI was associated with LASr, LAScd, and LASct (β = − 0.34, CI − 0.54 to − 0.13; β = − 0.22, CI − 0.38 to − 0.06; β = − 0.10, CI − 0.20 to − 0.004). Obesity patients without known cardiovascular disease have impairment in all phases of LA function. LA dysfunction in obesity may be an early sign of cardiac disease and may be a predictor for developing HFpEF. LASr improved 1 year after bariatric surgery, indicating potential reversibility of LA function in obesity.

Original languageEnglish
JournalInternational Journal of Cardiovascular Imaging
DOIs
Publication statusE-pub ahead of print - 28 Oct 2022

Bibliographical note

Funding Information:
This work was supported by a Grant from Stichting BeterKeten.

Publisher Copyright:
© 2022, The Author(s).

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