Cardiac Remodeling Patterns in Severe Obesity According to Arterial Hypertension Grade
The purpose of this study is to correlate the left ventricular hypertrophy (LVH) patterns according to severe obesity and arterial hypertension (AHT) grades.
A cross-sectional prospective study was conducted in 379 patients with severe obesity. Obesity was classified according to the BMI in the following: morbidly obese (MO; 40 < BMI < 50 kg/m2) and super obese (SO; BMI > 50 kg/m2). The AHT was classified into classes 1 and 2 according to American Heart Association. The presence of LVH and the pattern of cardiac remodeling were determined by transthoracic echocardiography.
LVH was present in 58.6% of patients. Obesity and AHT had additive effects in LVH prevalence. LVH was found in 32.9 and 46.7% of MO with AHT grades 1 and 2, respectively. LVH was diagnosed in 39.1% in SO with AHT grade 1 and in 50% of AHT grade 2. Patients with AHT presented a significantly higher risk of developing LVH (OR 1.97; p = 0.003). Hypertension grade was also a determinant variable in the development of LVH. Patients with AHT 2 had 4.31-fold greater risk (p < 0.001) when compared to normotensive patients. BMI was only considered an independent risk factor for LVH in patients with BMI greater than 47.17 kg/m2 (OR 1.62; p = 0.023).
AHT is a stronger predictive factor of LVH than obesity grade.
KeywordsSevere obesity Hypertension Left ventricular hypertrophy
Contribution of Each Author
Authors RC and MAS were responsible for conception and design and also performed drafting and critical revision of the manuscript. Authors VAA, CCOB, FOC, AFC, and DP were responsible for data review and calculations of ventricular mass in all patients. All authors participated of the analysis and interpretation of data. All authors contributed to and have approved the final manuscript. All authors take public responsibility for its content.
The study was supported by São Paulo Research Foundation (FAPESP), grant 2015/12265-4.
Compliance with Ethical Standards
The current study was performed according to the ethical recommendations of the Declaration of Helsinki, and it was approved by the Hospital das Clinicas Ethical Committee. Informed consent was obtained from all individual participants included in the study.
Conflict of Interest
The authors declare that they have no conflict of interest.
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