Structural myocardial remodeling in women and men with stage 1 obesity: results of a comparative study

Aim. To conduct a comparative analysis of the adipose tissue (AT) distribution and left myocardial geometry and functional parameters in women and men with class 1 obesity without previously diagnosed cardiovascular diseases.

Material and methods. The analysis included 88 patients with class 1 obesity aged 25-50 years who had no history of cardiovascular and non-communicable diseases. Depending on sex, the subjects were divided into 2 groups. In each group, the structural and functional cardiac parameters were assessed, including longitudinal strain indices and AT distribution. The studies were performed on a Philips EPIQ CVx 2D ultrasound system by one specialist.

Results. Women had higher absolute (49,0 [41,0;57,5] vs, 44,0 [37,0;54,0] ml, p=0,076) and indexed left atrial (LA) volumes (18,3 [14,6;20,1] vs 14,7 [12,0;17,2] ml/m², p=0,015) than men, as well as a higher left ventricular mass index (42,2 [37,2;47,8] vs 33,0 [31,3;41,1] g/m²,7, p=0,001). Men had higher left atrial strain during reservoir phase (LASr) (p=0,047) than women, whereas women were more likely to have LA dilation (30 vs 10%, p=0,001). In men, the pro­ba­bility of an increase in LA size was 5,2 times lower than in women (odds ratio (OR) 0,192; 95% confidence interval: 0,068-0,541, p=0,002). Wo­men had a significantly higher probability of a decrease in LASr (OR 3,2, p=0,022), which may be associated with specifics of visceral AT, including epicardial, distribution.

Conclusion. Women are more likely to have LA dysfunction, which is probably due to the greater severity of visceral obesity. The established relationship with epicardial AT thickness confirms the importance of its assessment in the standard echocardiographic protocol. The results obtained suggest that weight loss, especially in women, should be a priority for the prevention of cardiovascular events.

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