Diastolic dysfunction and exercise capacity in patients with metabolic syndrome and overweight/obesity
Background: Left ventricle diastolic dysfunction (LVDD) is a common finding in high risk individuals, its presence being associated with reduced exercise capacity (EC). We assessed the prevalence of LVDD, applying the 2016 guidelines of the American Society of Echocardiography (ASE)/European Associa...
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Format: | Article |
Language: | English |
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Elsevier
2019-03-01
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Series: | International Journal of Cardiology: Heart & Vasculature |
Online Access: | http://www.sciencedirect.com/science/article/pii/S2352906718301696 |
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Article |
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DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Angel M. Alonso-Gómez Lucas Tojal Sierra Elena Fortuny Frau Leire Goicolea Güemez Ane Aboitiz Uribarri María P. Portillo Estefanía Toledo Helmut Schröder Jordi Salas-Salvadó Fernando Arós Borau |
spellingShingle |
Angel M. Alonso-Gómez Lucas Tojal Sierra Elena Fortuny Frau Leire Goicolea Güemez Ane Aboitiz Uribarri María P. Portillo Estefanía Toledo Helmut Schröder Jordi Salas-Salvadó Fernando Arós Borau Diastolic dysfunction and exercise capacity in patients with metabolic syndrome and overweight/obesity International Journal of Cardiology: Heart & Vasculature |
author_facet |
Angel M. Alonso-Gómez Lucas Tojal Sierra Elena Fortuny Frau Leire Goicolea Güemez Ane Aboitiz Uribarri María P. Portillo Estefanía Toledo Helmut Schröder Jordi Salas-Salvadó Fernando Arós Borau |
author_sort |
Angel M. Alonso-Gómez |
title |
Diastolic dysfunction and exercise capacity in patients with metabolic syndrome and overweight/obesity |
title_short |
Diastolic dysfunction and exercise capacity in patients with metabolic syndrome and overweight/obesity |
title_full |
Diastolic dysfunction and exercise capacity in patients with metabolic syndrome and overweight/obesity |
title_fullStr |
Diastolic dysfunction and exercise capacity in patients with metabolic syndrome and overweight/obesity |
title_full_unstemmed |
Diastolic dysfunction and exercise capacity in patients with metabolic syndrome and overweight/obesity |
title_sort |
diastolic dysfunction and exercise capacity in patients with metabolic syndrome and overweight/obesity |
publisher |
Elsevier |
series |
International Journal of Cardiology: Heart & Vasculature |
issn |
2352-9067 |
publishDate |
2019-03-01 |
description |
Background: Left ventricle diastolic dysfunction (LVDD) is a common finding in high risk individuals, its presence being associated with reduced exercise capacity (EC). We assessed the prevalence of LVDD, applying the 2016 guidelines of the American Society of Echocardiography (ASE)/European Association of Cardiovascular Imaging (EACVI), in a population with overweight/obesity and metabolic syndrome and its association with EC. Methods and results: This was a prospective, cross-sectional study of a cohort of 235 patients (mean age of 65 ± 5 years old and 33% female) without heart disease and an ejection fraction >50% who underwent a complete echocardiographic assessment and cardiopulmonary exercise testing. Individuals meeting three or more criteria of the 2016 ASE/EACVI guidelines are considered to have LVDD, while tests are considered indeterminate in those meeting only two. Overall, 178 (76%) of our patients met one echocardiographic cutoff value for LVDD, 91 (39%) met two and 7 (3%) three or more. Patients meeting three cutoffs values showed a significant reduction in maximal oxygen uptake (16 ± 3 vs. 19.6 ± 5 ml/kg/min, p < .05), unlike those with indeterminate tests. In multiple regression analysis, meeting three cutoffs was associated with number of METS (ß = −2.2, p = .018). In exploratory analysis, using two criteria based on cutoffs different from those proposed in the guidelines, we identified groups with different EC. Conclusions: The application of 2016 ASE/EACVI guidelines limited the prevalence of LVDD to 3%. This group showed a clear reduction of the EC. New echocardiographic cutoff values proposed in this study allow us to establish subgroups with different levels of EC. Keywords: Diastolic dysfunction, Doppler echocardiography, Exercise capacity, Metabolic syndrome, Obesity |
url |
http://www.sciencedirect.com/science/article/pii/S2352906718301696 |
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doaj-31542a47c6ea47a095721a32869e9ecc2020-11-24T21:07:30ZengElsevierInternational Journal of Cardiology: Heart & Vasculature2352-90672019-03-01226772Diastolic dysfunction and exercise capacity in patients with metabolic syndrome and overweight/obesityAngel M. Alonso-Gómez0Lucas Tojal Sierra1Elena Fortuny Frau2Leire Goicolea Güemez3Ane Aboitiz Uribarri4María P. Portillo5Estefanía Toledo6Helmut Schröder7Jordi Salas-Salvadó8Fernando Arós Borau9Department of Cardiology, Organización Sanitaria Integrada (OSI) ARABA, University Hospital Araba, Vitoria-Gasteiz, Spain; Centro de Investigación Biomédica en Red de la Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Corresponding author at: Servicio de Cardiología, Hospital Universitario Araba, c/ Jose Atxotegui s/n°, 01009 Vitoria-Gasteiz, Alava, Spain.Department of Cardiology, Organización Sanitaria Integrada (OSI) ARABA, University Hospital Araba, Vitoria-Gasteiz, SpainDepartment of Cardiology, University Hospital Son Espases, Palma de Mallorca, Islas Baleares, SpainDepartment of Cardiology, Organización Sanitaria Integrada (OSI) ARABA, University Hospital Araba, Vitoria-Gasteiz, SpainDepartment of Cardiology, Organización Sanitaria Integrada (OSI) ARABA, University Hospital Araba, Vitoria-Gasteiz, SpainNutrition and Obesity Group, Department of Nutrition and Food Science, Faculty of Pharmacy and Lucio Lascaray Research Institute, University of País Vasco (UPV/EHU), 01006 Vitoria, Spain; Centro de Investigación Biomédica en Red de la Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, SpainUniversity of Navarra, Department of Preventive Medicine and Public Health, Faculty of Medicine, IdiSNA, Pamplona, Spain; Centro de Investigación Biomédica en Red de la Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, SpainCardiovascular Risk and Nutrition (CARIN), Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain; CIBER Epidemiologia y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, SpainHuman Nutrition Unit, Faculty of Medicine and Health Sciences, IISPV, Rovira i Virgili University, Reus, Spain; Centro de Investigación Biomédica en Red de la Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, SpainDepartment of Cardiology, Organización Sanitaria Integrada (OSI) ARABA, University Hospital Araba, Vitoria-Gasteiz, Spain; Centro de Investigación Biomédica en Red de la Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; University of the Basque Country/Euskal Herriko Univertsitatea (UPV/EHU), Department of Medicine, Medical Education Unit, Teaching Unit of Medicine, Vitoria-Gasteiz, Álava, SpainBackground: Left ventricle diastolic dysfunction (LVDD) is a common finding in high risk individuals, its presence being associated with reduced exercise capacity (EC). We assessed the prevalence of LVDD, applying the 2016 guidelines of the American Society of Echocardiography (ASE)/European Association of Cardiovascular Imaging (EACVI), in a population with overweight/obesity and metabolic syndrome and its association with EC. Methods and results: This was a prospective, cross-sectional study of a cohort of 235 patients (mean age of 65 ± 5 years old and 33% female) without heart disease and an ejection fraction >50% who underwent a complete echocardiographic assessment and cardiopulmonary exercise testing. Individuals meeting three or more criteria of the 2016 ASE/EACVI guidelines are considered to have LVDD, while tests are considered indeterminate in those meeting only two. Overall, 178 (76%) of our patients met one echocardiographic cutoff value for LVDD, 91 (39%) met two and 7 (3%) three or more. Patients meeting three cutoffs values showed a significant reduction in maximal oxygen uptake (16 ± 3 vs. 19.6 ± 5 ml/kg/min, p < .05), unlike those with indeterminate tests. In multiple regression analysis, meeting three cutoffs was associated with number of METS (ß = −2.2, p = .018). In exploratory analysis, using two criteria based on cutoffs different from those proposed in the guidelines, we identified groups with different EC. Conclusions: The application of 2016 ASE/EACVI guidelines limited the prevalence of LVDD to 3%. This group showed a clear reduction of the EC. New echocardiographic cutoff values proposed in this study allow us to establish subgroups with different levels of EC. Keywords: Diastolic dysfunction, Doppler echocardiography, Exercise capacity, Metabolic syndrome, Obesityhttp://www.sciencedirect.com/science/article/pii/S2352906718301696 |