INFLUENCE OF LEFT-VENTRICULAR MASS ON LEFT-VENTRICULAR DIASTOLIC FILLING IN NORMOTENSIVE MORBID-OBESITY

To identify factors influencing left ventricular (LV) diastolic fillin g in patients with morbid obesity, we performed transthoracic and Dopp ler echocardiography on 50 subjects whose actual body weight was great er than or equal to twice their ideal body weight and on 50 normal lea n control subjects. The transmitral Doppler E/A ratio and E wave decel eration half-time were used to assess LV diastolic filling. Significan t negative correlations were seen between the VA ratio and the LV inte rnal dimension in diastole (r=0.819, p=0.0001), systolic blood pressur e (r=0.751, p=0.0001), LV end-systolic wall stress (r=0.782, p=0.0001) , and LV mass/height index (r=0.901, p=0.0001). Significant positive c orrelations were seen between the E wave deceleration half-time and th e LV internal dimension in diastole (r=0.743, p=0.0001), systolic bloo d pressure (r=0.789, p=0.0001), LV end-systolic wall stress (r=0.828, p=0.0001), and LV mass/height index (r=0.831, p=0.0001). No correlatio n was seen between diastolic blood pressure and either index of LV dia stolic fil ling. Thus increasing LV mass is associated with progressiv e impairment of LV diastolic filling in morbidly obese individuals. Th e aforementioned alterations in LV loading conditions may contribute t o impairment of LV diastolic filling directly or by increasing LV mass .