Influence of abdominal circumference on the inappropriateness of LV mass and diastolic dysfunction in non-obese patients.

초록

Background and Objectives: Non-hemodynamic factors involved in hypertrophy of left ventricle include genetic traits and humoral factors such as adipokines. We investigated the effect of the abdominal obesity on the left ventricular hypertrophy which can not be explained by blood pressure, stroke work in non-obese patients. Subjects and Methods: 312 non-obese patient data were analyzed for their echocardiographic parameters for left ventricular mass and the indices for diastolic function. Inappropriateness was defined by observed/predicted ratio(OPR) of LV mass > 132%. Predicted LV mass was calculated by the equation of 54.9 + 7.62 x height(m2.7) + 0.67 x stroke work - 13.2 x gender(male =1, female =2). Abdominal obesity was defined by abdominal circumference > 80cm in female and > 90 cm in male. Obesity was defined by body mass index > 25 kg/m2. Results: In a multiple logistic regression analysis, diabetes(OR:3.956(1.31-11.9)), abdominal obesity(OR:4.347(1.83-10.3)), 10 year age(OR:1.365(1.0-1.85)) were the determinants of inappropriate LV mass. In a multiple linear regression model, abdominal circumference was the only factor affecting E/A ratio( =-0.265, p=0.0001) other than age and heart rate. But abdominal obesity was not a risk factor for LV relaxation abnormality(p=0.29, OR:1.58(0.667-2.78). In inappropriate LV mass group(n=65), metabolic syndrome was much higher than appropriate LV mass group(n=247)(58.3% vs 25.5%, p=0.001). Conclusion: Abdominal obesity among the components of metabolic syndrome is most useful tools to predict early increase of left ventricular mass which is inappropriate even in non-obese patients.