Turk Kardiyol Dern Ars. Ahead of Print: TKDA-72246 | DOI: 10.5543/tkda.2020.72246
Comparison of Myocardial performance index and right ventricular myocardial acceleration during isovolumic contraction in detecting right ventricular dysfunction in obese patients
, Mehmet Sertaç Alpaydın
Konya Education And Research Hospital Department Of Cardiology
OBJECTIVE Although obesity is a risk factor for heart failure, studies analyzing the effect of obesity on heart functions were mainly conducted on the left side of the heart. In this study, we analyzed the effect of severity of obesity on right heart functions and we compared the sensitivity and specificity of different echocardiographic modalities on detecting right heart dysfunction.
METHODS 116 subjects included. Included subjects divided into age and sex-matched 4 groups according to the body mass index (BMI). Right heart functions were evaluated with transthoracic echocardiography.
RESULTS Right atrium (RA) diameter was significantly larger in obese and morbid obese groups, right ventricle (RV) diameter was significantly larger only in the morbidly obese group. Right ventricular isovolumetric acceleration (R-IVA) was significantly lower (p=0.020; p<0.001; p<0.001), myocardial performance index (MPI) was significantly higher in overweight, obese and morbid obese groups (p=0.015; p<0.001; p<0.001). There were; strong positive correlation between MPI and BMI (r=0.833, p<0.001), and moderate negative correlation between R-IVA and BMI (r=-0.547, p<0.001). A cut-off value of 30.45 kg/m2 was associated with % 93.3 sensitivity and % 94.3 specificity in the prediction of RV systolic dysfunction defined by MPI. A cut-off value of 30.50 kg/m2 was associated with % 76.7 sensitivity and % 72.3 specificity in the prediction of RV systolic dysfunction defined by R-IVA.
CONCLUSION Obesity significantly affects the right heart functions and there is a significant correlation between the degree of obesity and right heart functional deterioration. Additionally, BMI could be used to predict RV systolic dysfunction.
Obesity, right ventricle, myocardial performance index, isovolumetric acceleration
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Corresponding Author: Murat Ziyrek, Türkiye