Abstract
Obese patients may have a phase of asymptomatic left ventricular dysfunction. A combined myocardial performance index (MPI) has been demonstrated to be a useful index to estimate left ventricular function and to predict the prognosis of patients with heart failure. The objective of the study was to determine the influence of weight loss on MPI. A total of 18 obese patients (3 men, 15 women, mean age 49.6 ± 5.5 years, body mass index [BMI] >30 kg/m2) were investigated in the study. All patients were treated with a multidisciplinary approach consisting of a hypocaloric diet and orlistat therapy (120 mg three times daily), and all of them underwent two-dimensional and Doppler echocardiographic examination two times before starting the study and after a period of weight loss. Using echo-Doppler methods, ejection fraction, peak velocities of early (E) and late (A) diastolic filling, the E/A ratio, deceleration time (DT), isovolumic contraction time (IVCT), isovolumic relaxation time, ejection time, and MPI were measured. The MPI was obtained by subtraction ejection time from the interval between cessation and onset of the mitral flow. All patients lost at least 10% of their initial body weight, with a mean decrease of 10.8 ± 3.7 kg. This was associated with significant reductions in BMI with a mean decrease 4.5 ± 1.4 kg/m2. Compared with baseline, after weight loss the E/A ratio of 1.01 ± 0.22 before treatment increased to 1.17 ± 0.26 (P = 0.012), left ventricular mass index decreased from 88 ± 23 to 82 ± 19 g/m2 (P = 0.028), IVCT from 71 ± 20 to 53 ± 30 ms (P = 0.004), DT from 233.65 ± 38.14 to 196.72 ± 47.73 s (P = 0.004), and MPI from 0.63 ± 0.13 to 0.50 ± 0.13 (P = 0.0001). Weight loss ameliorates MPI and seems to be a clinically relevant measurement of left ventricular global function, and may prove to be a valuable tool in assessing the risk of developing heart failure.
Similar content being viewed by others
References
S Kenchaiah JC Evans D Levy PW Wilson EJ Benjamin MG Larson WB Kannel RS Vasan (2002) ArticleTitleObesity and the risk of heart failure N Engl J Med 47 305–313
DL Brutsaert (2000) ArticleTitleDiagnosing primary diastolic heart failure Eur Heart J 21 94–96 Occurrence Handle10.1053/euhj.1999.1669 Occurrence Handle1:STN:280:DC%2BD3c7gsFamug%3D%3D Occurrence Handle10637079
J Arnlov E Ingelsson U Riserus B Andren L Lind (2004) ArticleTitleMyocardial performance index, a Doppler-derived index of global left ventricular function, predicts congestive heart failure in elderly men Eur Heart J 25 2220–2225 Occurrence Handle10.1016/j.ehj.2004.10.021 Occurrence Handle15589639
C Tei LH Ling DO Hodge KR Bailey JK Oh RJ Rodeheffer AJ Tajik JB Seward (1995) ArticleTitleNew index of combined systolic and diastolic myocardial performance: a simple and reproducible measure of cardiac function a study in normal and dilated cardiomyopathy J Cardiol 26 357–366 Occurrence Handle1:STN:280:BymC2czltFM%3D Occurrence Handle8558414
S Rössner L Sjöström R Noack AE Meinders G Noseda (2000) ArticleTitleWeight loss, weight maintenance, and improved cardiovascular risk factors after 2 years treatment with orlistat for obesity Obes Res 8 58–61
JA Lakoumentas FK Panou VK Kotseroglou KI Aggeli PK Harbis (2005) ArticleTitleThe Tei index of myocardial performance: applications in cardiology Hell J Cardiol 46 52–58
S Chakko M Mayor MD Allison KM Kessler BJ Materson RJ Myerburg (1991) ArticleTitleAbnormal left ventricular diastolic filling in eccentric left ventricular hypertrophy of obesity Am J Cardiol 68 95–98 Occurrence Handle10.1016/0002-9149(91)90718-Z Occurrence Handle1:STN:280:By6B1c7mvFc%3D Occurrence Handle1829321
MF Stoddard K Tseuda M Thomas S Dillon J Kupersmith (1992) ArticleTitleThe influence of obesity on left ventricular filling and systolic function Am Heart J 124 694–699 Occurrence Handle1:STN:280:By2A1cvhvVU%3D Occurrence Handle1514498
LL Crisostomo LM Araujo E Camara C Carvalho FA Silva M Vieira A Rabelo SuffixJr (1999) ArticleTitleComparison of left ventricular mass and function in obese versus nonobese women <40 years of age Am J Cardiol 84 1127–1129 Occurrence Handle10.1016/S0002-9149(99)00519-6 Occurrence Handle1:STN:280:DC%2BD3c%2FjsV2ksA%3D%3D Occurrence Handle10569684
JK Alexander (1998) The heart and obesity RW Alexandre RC Schlant V Fuster (Eds) Hurst's the heart, arteries and veins McGraw Hill New York 2408–2410
RH Eckel (1997) ArticleTitleObesity and heart disease: a statement for healthcare professionals from the Nutrition Committee, American Heart Association Circulation 96 3248–3250 Occurrence Handle1:STN:280:DyaK1c%2FksF2lug%3D%3D Occurrence Handle9386201
R Lapu-Bula A Robert M De Kock AM D'Hondt JM Detry JA Melin JL Vanoverschelde (1999) ArticleTitleRelation of exercise capacity to left ventricular systolic function and diastolic filling in idiopathic or ischemic dilated cardiomyopathy Am J Cardiol 83 728–734 Occurrence Handle10.1016/S0002-9149(98)00979-5 Occurrence Handle1:STN:280:DyaK1M7nvVGisA%3D%3D Occurrence Handle10080427
JK Alexander (1985) ArticleTitleThe cardiomyopathy of obesity Prog Cardiovasc Dis 27 325–324 Occurrence Handle1:STN:280:BiqC2c7gtFA%3D Occurrence Handle3975428
EH Estes HO Seiker HD Mcintosh GA Kelser (1957) ArticleTitleReversible cardiopulmonary syndrome with extreme obesity Circulation 16 179–187 Occurrence Handle13447161
M Pascual DA Pascual F Soria T Vicente AM Hernandez FJ Tebar M Valdes (2003) ArticleTitleEffects of isolated obesity on systolic and diastolic left ventricular function Heart 89 1152–1156 Occurrence Handle10.1136/heart.89.10.1152 Occurrence Handle1:STN:280:DC%2BD3svjsVWqug%3D%3D Occurrence Handle12975404
C Tei KS Dujardin DO Hodge RA Kyle JA Tajik JB Seward (1996) ArticleTitleDoppler index combining systolic and diastolic myocardial performance: clinical value in cardiac amyloidosis J Am Coll Cardiol 27 658–664
KS Dujardin C Tei TC Yeo DO Hodge A Rossi JB Seward (1998) ArticleTitlePrognostic value of a Doppler index combining systolic and diastolic performance in idiopathic-dilated cardiomyopathy Am J Cardiol 82 1071–1076 Occurrence Handle10.1016/S0002-9149(98)00559-1 Occurrence Handle1:STN:280:DyaK1M%2Fjt1ChsA%3D%3D Occurrence Handle9817484
SH Poulsen SE Jensen JC Nielsen JE Moller K Egstrup (2000) ArticleTitleSerial changes and prognostic implications of a Doppler-derived index of combined left ventricular systolic and diastolic myocardial performance in acute myocardial infaction Am J Cardiol 85 19–25 Occurrence Handle10.1016/S0002-9149(99)00599-8 Occurrence Handle1:STN:280:DC%2BD3M%2FjvFCmsw%3D%3D Occurrence Handle11078230
KJ Harjai L Scott K Vivekananthan E Nunez R Edupuganti (2002) ArticleTitleThe Tei index: a new prognostic index for patients with symptomatic heart failure J Am Soc Echocardiogr 15 864–868 Occurrence Handle12221401
MJ Garcia JD Thomas AL Klein (1998) ArticleTitleNew Doppler echocardiographic applications for the study of diastolic function J Am Coll Cardiol 32 865–875 Occurrence Handle1:STN:280:DyaK1cvjvFKnsg%3D%3D Occurrence Handle9768704
H Sasao R Noda T Hasegawa A Endo H Oimatsu T Takada (2004) ArticleTitlePrognostic value of the Tei index combining systolic and diastolic myocardial performance in patients with acute myocardial infarction treated by successful primary angioplasty Heart Vessels 19 68–74 Occurrence Handle10.1007/s00380-003-0735-7 Occurrence Handle15042390
M Ono K Tanabe T Asanuma H Yoshitomi H Schimizu Y Ohta T Schimada (2001) ArticleTitleDoppler echocardiography-derived index of myocardial performance (TEI index): comparison with brain natriuretic peptide levels in various heart disease Jpn Circ J 65 637–642 Occurrence Handle1:STN:280:DC%2BD38%2FhvFOqsg%3D%3D Occurrence Handle11446498
SH Poulsen JC Nielsen HR Andersen (2000) ArticleTitleThe influence of heart rate on the Doppler-derived myocardial performance index J Am Soc Echocardiogr 13 379–384 Occurrence Handle1:STN:280:DC%2BD3c3msFyltA%3D%3D Occurrence Handle10804435
C Tei RA Nishimura JB Seward AJ Tajik (1997) ArticleTitleNoninvasive Doppler-derived myocardial performance index: correlation with simultaneous measurements of cardiac catheterization measurements J Am Soc Echocardiogr 10 169–178 Occurrence Handle1:STN:280:ByiB3sjkvFE%3D Occurrence Handle9083973
C Bruch A Schmermund D Marin M Katz T Bartel J Schaar R Erbel (2000) ArticleTitleTei index in patients with mild-to-moderate congestive heart failure Eur Heart J 21 1888–1895 Occurrence Handle10.1053/euhj.2000.2246 Occurrence Handle1:STN:280:DC%2BD3M%2FnvFensw%3D%3D Occurrence Handle11052862
M Borzoee Z Kheirandish (2004) ArticleTitleDoppler-derived myocardial performance index in healty children in Shiraz Iran J Med Sci 29 85–89
R Marfella K Esposito M Siniscalchi F Cacciapuoti F Giugliano D Labriola M Ciotola C Di Palo L Misso D Giugliano (2004) ArticleTitleEffect of weight loss on cardiac synchronization and proinflammatory cytokines in premenopausal obese women Diabetes Care 27 47–52 Occurrence Handle1:CAS:528:DC%2BD2cXmvV2jsg%3D%3D Occurrence Handle14693965
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Dayi, S., Kasikcioglu, H., Uslu, N. et al. Influence of weight loss on myocardial performance index. Heart Vessels 21, 84–88 (2006). https://doi.org/10.1007/s00380-005-0858-0
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/s00380-005-0858-0