Journal
INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING
Volume 29, Issue 5, Pages 1043-1050Publisher
SPRINGER
DOI: 10.1007/s10554-012-0174-6
Keywords
Obesity; Weight loss; P-31 magnetic resonance spectroscopy; Diastole
Funding
- Wellcome Trust
- Oxford Partnership Comprehensive Biomedical Research Centre
- Department of Health's NIHR Biomedical Research Centres funding scheme
- Oxford BHF Centre of Research Excellence
- British Heart Foundation [RG/07/004/22659, RG/11/9/28921, FS/10/002/28078, PS/02/002/14893] Funding Source: researchfish
- Medical Research Council [G0601490] Funding Source: researchfish
- National Institute for Health Research [NF-SI-0512-10005] Funding Source: researchfish
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A reduced myocardial phosphocreatine/adenosine triphosphate (PCr/ATP) ratio is linked to both diastolic dysfunction and heart failure. Although obesity is well known to cause diastolic dysfunction a link to impaired cardiac energetics has only recently been established. We assessed whether or not long-term weight loss in obesity, which is known to reduce mortality, is accompanied by both improved cardiac energetics and diastolic function. Normal weight (BMI 22 +/- A 2; n = 18) and obese subjects (BMI 34 +/- A 4; n = 13) underwent cine-MRI (1.5 Tesla) to determine left ventricular diastolic function using volume-time curve analysis, and P-31-MR spectroscopy (3 Tesla) to assess cardiac energetics (PCr/ATP ratio). Obese subjects (n = 13) underwent repeat assessment after 1 year of supervised weight loss. Obesity, in the absence of identifiable cardiovascular risk factors, was associated with significantly impaired myocardial high energy phosphate metabolism (PCr/ATP ratio, normal; 2.03 +/- A 0.27 vs. obese; 1.58 +/- A 0.47, p = 0.002) and significantly lower peak diastolic filling rate (normal; 4.8 +/- A 0.8 vs. obese; 3.8 +/- A 0.7 EDV/s, p = 0.01). Weight loss (on average 9 kg, 55 % excess weight) over 1 year resulted in a 24 % increase in PCr/ATP ratio (p = 0.01) and an 18 % improvement in peak diastolic filling rate (p = 0.01). Myocardial PCr/ATP ratio remained positively correlated with peak diastolic filling rate after weight loss (r = 0.63, p = 0.02). In obesity, weight loss improves impaired cardiac energetics and myocardial relaxation. Improved myocardial energetics appear to play a key role in diastolic functional recovery accompanying weight loss.
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