S. Seto et al., Influence of mild to moderate obesity on left ventricular stress filling pattern in hypertension, HYPERTENS R, 21(4), 1998, pp. 245-250
In resting condition, obese subjects are described as having impaired diast
olic filling. To examine the effect of mild to moderate obesity on left ven
tricular diastolic performance during stress in hypertension, we determined
the filling responses to dynamic submaximal exercise in 19 obese hypertens
ive patients (body mass index, 26 to 30 kg/m(2)) with a normal left ventric
ular structure, 19 age- and sex-matched, non obese hypertensive patients, a
nd 19 age- and sex-matched, non-obese normotensive controls (mean age, 55 /- 3 yr). Doppler echocardiographic studies were performed at baseline and
1 min after exercise on a supine ergometer bicycle. At rest, systolic funct
ion and filling indices, peak velocities of early (E) and late (A) filling,
and their ratio (E/A), were similar in the two hypertensive groups, while
normotensive controls had higher peak velocities of E and E/A. At a maximum
workload of 75 W, blood pressure and heart rate increased similarly in the
two hypertensive groups. Peak velocities of E and A increased significantl
y after exercise. The percentage change in the peak velocity of E was great
er in obese hypertensive patients than in non-obese hypertensive patients a
nd normotensive controls (23 +/- 4 us. 12+/-3 and 14 +/- 3%, p < 0.05). Per
centage changes in A and EIA were similar in the three groups. Our study su
ggests that mild to moderate obesity does not further worsen left ventricul
ar diastolic filling at rest and mitigates diastolic filling abnormalities
after exercise in hypertensive patients.