EARLY LEFT VENTRICULAR REMODELING AND ALTERED DIASTOLIC FILLING IN APPARENTLY HEALTHY OBESE ADULTS: A CROSS-SECTIONAL ECHOCARDIOGRAPHIC STUDY FROM WESTERN INDIA

Abstract

Background: Obesity is associated with adverse cardiac remodeling and may cause subclinical left ventricular (LV) structural and functional abnormalities before the onset of overt cardiovascular disease. This study evaluated the impact of obesity on LV structure and function in apparently healthy adults from Western India using conventional and tissue Doppler echocardiography. Methods: In this cross-sectional study, 100 apparently healthy adults (50 obese and 50 non-obese) were recruited using consecutive sampling. Participants with systemic illnesses, including hypertension, diabetes mellitus, and coronary artery disease, were excluded. All subjects underwent standardized two-dimensional, M-mode, pulsed-wave Doppler, and tissue Doppler echocardiography. LV systolic function was assessed using left ventricular ejection fraction (LVEF) and mitral annular systolic velocity (s′), while diastolic function was evaluated using transmitral E and A velocities, E/A ratio, isovolumic relaxation time, and mitral annular e′ and a′ velocities. LV mass index (LVMI) was calculated using Devereux formula. Groups compared using independent-samples t-test, and multiple linear regression assessed independent associations between BMI and echocardiographic parameters after adjustment for age and sex. Results: Obese participants had significantly higher LVMI, higher transmitral A-wave velocity, and lower E/A ratio than non-obese controls (all p<0.001), whereas LVEF and s′ remained comparable. BMI independently predicted LVMI (β=3.91; 95% CI: 3.02–4.80; p<0.001), A-wave velocity (β=1.17; 95% CI: 0.63–1.71; p<0.001), and E/A ratio (β=−0.018; 95% CI: −0.029 to −0.007; p=0.001). Conclusions: Apparently healthy obese adults exhibit early LV structural remodeling and impaired diastolic relaxation despite preserved systolic function. Conventional echocardiography may facilitate early detection of obesity-related myocardial remodeling.