Comparative assessment of echocardiographic parameters in persons without diagnosed chronic non-communicable diseases depending on body mass index

Aim: To compare the indicators of structural remodeling and intracardiac hemodynamics in people without previously diagnosed chronic non-communicable diseases, depending on body mass index (BMI).

Material and Methods. We analyzed the data of 123 people aged 21 to 59 years who did not have chronic non-infectious diseases and did not take any drug therapy that affects the indicators of central and peripheral hemodynamics, as well as lipid, carbohydrate and fat metabolism. All the examined persons were divided depending on the BMI into 2 groups, comparable in sex, but with age differences. The first group consisted of 60 people (75% women) with a BMI < 30 kg/m², whose median age was 40 years (Q₁–Q₃: 35–48 years). The second group included 63 subjects (76.1% women) with BMI ≥ 30 kg/m² at the age of 48.5 years (Q₁–Q₃: 38–54 years). Structural and functional parameters of the heart were assessed during transthoracic echocardiography, which was performed on the Philips EPIQ CVx 2D ultrasound machine by one specialist.

Results. In the group of persons with increased BMI, the average values of the left ventricular relative wall thickness (RWT LV) were higher – 0.37 [0.34; 0.40] versus 0.41 [0.37; 0.47], p = 0.01; left ventricular mass index (LVMI) – 64.0 [53.0; 76.5] g/m² and 27.0 [23.1; 30.9] g/m^2,7 vs. 82.0 [70.0; 92.0] g/m² and 38.1 [34.5; 46.5] g/m^2,7, p = 0.01; epicardial fat (EF) – 5 [4; 6] mm vs. 8 [5; 10] mm, p = 0.01, left ventricular global longitudinal strain (LV GLS) –21.8 [–23.6…–19.7]% vs. –19.2 [–21.2…–18.2] %, p = 0.01. Statistically direct correlations of BMI with LVMI g/m^2,7  (ρ = 0.746; p = 0.01), EF (ρ = 0.563; p = 0.01), LV GLS (ρ = 0.418; p = 0 .01), RWT (ρ = 0.438; p = 0.01). With an increase in BMI by 1 kg/m², one should expect an increase in the thickness of EF by 0.172 mm, longitudinal deformation of the LV by 0.151%, RWT by 0.003, LVMI, g/m² by 1.200, LVMI g/m^2,7 by 1.116.

Conclusion. The increase in BMI is associated with changes in structural remodeling and systolic function of the LV. In individuals with increased BMI, to determine structural remodeling and changes in the geometry of the heart chambers, it is necessary to use growth indexing, to determine indicators of GLS LV, to determine the thickness of EF in order to detect intracardiac hemodynamic disorders in the early stages and timely prevention of complications.

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