Early LV remodelling patterns in overweight and obesity: Feasibility of cardiac CT to detect early geometric left ventricular changes

Background: Obesity is an in independent risk factor for cardiovascular disease. Goal: To describe the early LV remodelling pattern in patients with overweight and obesity and structurally normal hearts. Methods: Consecutive patients (n = 2374), with structurally normal hearts and BMI >= 18.5 kg/m(2), undergoing prospective mid-diastolic ECG gated CTCA were selected. Left ventricular mass (LVM) and Left ventricular mid-diastolic volume (LVMDV) were measured. The concentricity index (LVM/LVMDV) were calculated. According to the definitions of the World Health Organization (WHO), the patients were divided into weight categories. Results: The mean LVM +/- Std. deviation in the subgroups according to WHO classification was 101.68 +/- 28.99 g (normal weight), 115.79 +/- 29.14 g (overweight), 123.8 +/- 33.44 g (class I obesity), 125.85 +/- 32.89 g (class II obesity) and 132.45 +/- 37.85 g (class III obesity). (p <0.001) The mean LVMDV progressed with increasing WHO weight category from 112.37 +/- 36.46 in patients with normal BMI to 140.26 +/- 43.78 in patients with class III obesity. (p < 0.001) The concentricity index was 0.935 +/- 0.216 g/ml in patients with normal BMI, 0.979 +/- 0.253 g/ml, 1.058 +/- 0.635 g/ml, 0.996 +/- 0.284 g/ml and 0.9768 +/- 0.244 g/ml in patients with BMI categories 25-29.99, 30-34.99, 35-39.99 and >= 40 kg/m(2), respectively. Conclusions: Our study demonstrates a non-linear (inverse U-shape) relationship between increasing BMI class and concentricity index, reaching its maximum at a BMI of 30-34.99 kg/m(2). Further increase in BMI results in LV dilation. (C) 2019 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.