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Myocardial alterations and clinical implications associated with recovery of cardiac function in dilated cardiomyopathy with obesity.
MedLine Citation:
PMID:  23079086     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Obesity is associated with an increased risk of heart failure (HF) but the relationship between changes in cardiac function and the specific pathological features of dilated cardiomyopathy (DCM) with obesity, remains unknown. METHODS: Endomyocardial biopsies from the left ventricle (LV) were obtained from 50 patients with DCM, at the first-onset of decompensated HF. Thirty patients were obese (obese-group: body mass index >30kg/m(2)) and 20 were non-obese (lean-group). Clinical data were acquired at the admission, after one month and one year. RESULTS: The obese-group had higher systolic blood pressure (142.8±33.9 vs 113.6±18.7mmHg; p<0.001) and serum troponin-T level (0.049±0.07 vs 0.020±0.03ng/mL; p=0.022) than the lean-group. LV ejection fraction (LVEF) was not significantly different between groups, but after one year the obese-group had an improved LVEF (57.0±11.4 vs 44.3±17.1; p=0.003). Light microscopy revealed that the obese-group had larger cardiomyocytes (17.2±1.7 vs 16.4±1.4μm; p=0.033) and less myofilament lysis (37 vs 75%; p=0.008) with a higher density of lipid droplets (1.93±0.8 vs 0.94±0.7 /μm(2); p<0.001). Multivariate regression analysis revealed that independent predictors of LVEF improvement after 12months were diuretics use, nuclear diameter, and absence of myofilament lysis (p=0.024, 0.012 and 0.028, respectively). CONCLUSIONS: Cardiac function in most patients with DCM with obesity is reversible and myocardial structural changes are trivial even at the ultrastructural level.
Authors:
Tsunenori Saito; Kuniya Asai; Shigeru Sato; Gen Takagi; Hitoshi Takano; Hiroshi Takahashi; Masahiro Yasutake; Kyoichi Mizuno
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-10-15
Journal Detail:
Title:  International journal of cardiology     Volume:  -     ISSN:  1874-1754     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-19     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
Affiliation:
Department of Cardiovascular Medicine, Nippon Medical School Hospital, Tokyo, Japan. Electronic address: tnsaitonms@gmail.com.
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