Document Detail

Effects of catecholamine stress on diastolic function and myocardial energetics in obesity.
MedLine Citation:
PMID:  22368152     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Obesity is characterized by impaired cardiac energetics, which may play a role in the development of diastolic dysfunction and inappropriate shortness of breath. We assessed whether, in obesity, derangement of energetics and diastolic function is further altered during acute cardiac stress.
METHODS AND RESULTS: Normal-weight (body mass index, 22±2 kg/m(2); n=9-17) and obese (body mass index, 39±7 kg/m(2); n=17-46) subjects underwent assessment of diastolic left ventricular function (cine magnetic resonance imaging volume-time curve analysis) and cardiac energetics (phosphocreatine/ATP ratio; (31)P-magnetic resonance spectroscopy) at rest and during dobutamine stress (heart rate increase, 65±22% and 69±14%, respectively; P=0.61). At rest, obesity was associated with a 22% lower peak filling rate (P<0.001) and a 15% lower phosphocreatine/ATP ratio (1.73±0.40 versus 2.03±0.28; P=0.048). Peak filling rate correlated with fat mass, left ventricular mass, leptin, waist-to-hip ratio, and phosphocreatine/ATP ratio. On multivariable analysis, phosphocreatine/ATP was the only independent predictor of peak filling rate (β=0.50; P=0.03). During stress, a further reduction in phosphocreatine/ATP occurred in obese (from 1.73±0.40 to 1.53±0.50; P=0.03) but not in normal-weight (from 1.98±0.24 to 2.04±0.34; P=0.50) subject. For similar levels of inotropic stress, there were smaller increases in peak filling rate in obesity (38% versus 70%; P=0.01).
CONCLUSIONS: In obesity, cardiac energetics are further deranged during inotropic stress, in association with continued diastolic dysfunction. Myocardial energetics may play a key role in the impairment of diastolic function in obesity.
Oliver J Rider; Jane M Francis; Mohammed K Ali; Cameron Holloway; Tammy Pegg; Matthew D Robson; Damian Tyler; James Byrne; Kieran Clarke; Stefan Neubauer
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2012-02-24
Journal Detail:
Title:  Circulation     Volume:  125     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-03-27     Completed Date:  2012-08-13     Revised Date:  2014-06-10    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1511-9     Citation Subset:  AIM; IM    
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MeSH Terms
Body Mass Index*
Catecholamines / diagnostic use*
Diastole / physiology*
Energy Metabolism / physiology
Exercise Test / methods
Middle Aged
Myocardium / metabolism*
Obesity / complications,  metabolism*
Stress, Physiological / physiology*
Ventricular Function, Left / physiology
Grant Support
090532//Wellcome Trust; FS/10/002/28078//British Heart Foundation; G0601490//Medical Research Council; G0700796//Medical Research Council; G0900883//Medical Research Council; PS/02/002/14893//British Heart Foundation; RG/07/004/22659//British Heart Foundation; //Department of Health; //Wellcome Trust
Reg. No./Substance:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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