INTERRELATIONSHIP OF LEFT-VENTRICULAR MASS, SYSTOLIC FUNCTION AND DIASTOLIC FILLING IN NORMOTENSIVE MORBIDLY OBESE PATIENTS

OBJECTIVE: To determine the interrelationship of left ventricular (LV) mass, systolic function and diastolic relaxation in morbidly obese su bjects. METHOD: We obtained echocardiograms (M-mode, two dimension) an d cardiac Doppler studies (pulse wave, continuous wave colour flow) on 50 subjects whose actual body weight was greater than or equal to twi ce ideal body weight, LV mass/height index was calculated from echocar diographic data (Penn Convention), LV systolic function was assessed b y calculating LV fractional shortening, LV diastolic filling was asses sed by measuring the transmitral Doppler E/A ratio and the transmitral E wave deceleration time. RESULTS: There were significant positive co rrelations between LV mass/height index and the LV internal dimensions in diastole, systolic blood pressure, LV end-systolic wall stress and the transmitral E wave deceleration time, There were significant nega tive correlations between LV mass/height index and both LV fractional shortening and the transmitral Doppler E/A ratio, There were significa nt negative correlations between LV fractional shortening and the LV i nternal dimension in diastole, systolic blood pressure LV end-systolic wall stress and the transmitral E wave deceleration time, There was a significant positive correlation between LV fractional shortening and the transmitral Doppler E/A ratio, There were significant positive co rrelations between the transmitral E wave deceleration time and LV int ernal dimension in diastole, systolic blood pressure and LV end-systol ic wall stress, There were significant negative correlations between t he transmitral Doppler E/A ratio and the aforementioned variables. CON CLUSIONS: Unfavourable alterations in LV loading conditions contribute to the development of LV hypertrophy and impairment systolic dysfunct ion in morbidly obese subjects, Increasing LV mass and altered loading conditions may synergistically contribute to impairment of LV diastol ic filling in such individuals.