Journal article
Coronary vasodilator capacity in obesity and morbid obesity – divergent flow responses with left ventricular hypertrophy
International journal of cardiology. Heart & vasculature, Vol.60, 101785
10/2025
DOI: 10.1016/j.ijcha.2025.101785
PMCID: PMC12490525
PMID: 41050871
Abstract
To investigate the relationship between coronary vasodilator capacity, left ventricular hypertrophy, and regional myocardial function in two different disease entities of obese (OB) and morbidly obese (MOB) individuals.
13N-ammonia PET/CT determined myocardial blood flow (MBF) at rest and during pharmacologically induced hyperemia, and corresponding myocardial flow reserve (MFR) with 13N-ammonia PET/CT. Left ventricular mass (LVM), early diastolic flow (E), relaxation (e’) velocities, and global longitudinal strain (GLS) were acquired with 2D, trans-mitral Doppler and tissue Doppler, and speckle tracking echocardiography, respectively. Patients were then grouped according to the body mass index (BMI) into normal weight (NW: BMI 20.0–24.9 kg/m2, n = 27), overweight (OW: BMI 25.0–29.9 kg/ m2, n = 31), obesity (OB: BMI 30.0–39.9 kg/m2, n = 71), and morbid obesity (MOB: BMI ≥ 40 kg/m2, n = 97).
MFR progressively decreased from NW, OW, to OB (2.71 ± 0.84 vs. 2.50 ± 0.67 and 2.33 ± 0.63; p ≤ 0.04 by ANOVA), while it increased again in MOB comparable to NW (2.51 ± 0.51 vs. 2.71 ± 0.84, p = 0.70). In OB and MOB, MFR was inversely correlated with E velocity (cm/s), respectively (r = 0.32, SEE = 0.58, p = 0.02; and r = 0.29, SEE = 0.47, p = 0.02). Conversely, LVM, and GLS associated significantly and inversely with the MFR in OB (r = 0.27, SEE = 0.59, p = 0.05; and r = 0.31, SEE = 0.61, p = 0.04), but not in MOB, respectively (r = 0.13, SEE = 0.49, p = 0.27; and r = 0.05, SEE = 0.54, p = 0.73). Notably, GLS, E-velocity, and LVM remained independent predictors of MFR.
Divergent associations of coronary vasodilator capacity with left ventricular mass and early myocardial contractile dysfunction outline OB and MOB to affect left ventricular remodeling differently.
Details
- Title: Subtitle
- Coronary vasodilator capacity in obesity and morbid obesity – divergent flow responses with left ventricular hypertrophy
- Creators
- Elgin Ozkan - Washington University in St. Louis School of MedicineLiya Dai - Washington University in St. Louis School of MedicineFarrokh Dehdashti - Washington University in St. Louis School of MedicineKan Liu - Washington University in St. Louis School of MedicineThomas H. Schindler - Washington University in St. Louis School of Medicine
- Resource Type
- Journal article
- Publication Details
- International journal of cardiology. Heart & vasculature, Vol.60, 101785
- DOI
- 10.1016/j.ijcha.2025.101785
- PMID
- 41050871
- PMCID
- PMC12490525
- NLM abbreviation
- Int J Cardiol Heart Vasc
- ISSN
- 2352-9067
- eISSN
- 2352-9067
- Publisher
- Elsevier B.V
- Grant note
- Washington University, St. Louis, MO, USA: 12-3,271-93128 GE HealthcareNIH/NHLBI: 1R01HL142297-01A1, 1RO1HL171624 Scientific and Technological Research Council of Turkey, Ankara, Turkey: 53325897-115.02-476393 Lishui Central Hospital, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, China
This work was supported by Departmental fund from Washington University (No. 12-3,271-93128), St. Louis, MO, USA. Dr Schindler has received research grant support from GE Healthcare and NIH/NHLBI (1R01HL142297-01A1). Dr. Liu has received research grant support from NIH/NHLBI (1RO1HL171624). Dr. Ozkan is supported by a research fellowship grant from the The Scientific and Technological Research Council of Turkey, Ankara, Turkey (No 53325897-115.02-476393). Dr. Liya Dai is also supported by a research fellowship grant from the Lishui Central Hospital, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, China.
- Language
- English
- Date published
- 10/2025
- Academic Unit
- Cardiovascular Medicine; Internal Medicine
- Record Identifier
- 9984949230102771
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