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The International Journal of Cardiovascular Imaging

Published in:

01-02-2008 | Original paper

Obesity is associated with aortic enlargement and increased stiffness: an echocardiographic study

Authors: Attila Nemes, Henriette Gavallér, Éva Csajbók, Tamás Forster, Miklós Csanády

Published in: The International Journal of Cardiovascular Imaging | Issue 2/2008

Abstract

Background

Obesity may be associated with early vascular changes. The current study was designed to assess the relationship between obesity and aortic stiffness in two populations, one aged 18–40 years and one aged 41–64 years.

Methods

The study complied 121 subjects, all of them underwent a physical examination, transthoracic echocardiography and blood pressure measurement. Aortic stiffness index (β) was evaluated from aortic diameter and blood pressure data.

Results

β was higher in obese subjects both in the young (4.26 ± 1.57 vs. 6.88 ± 5.96, P < 0.05) and old patient populations (7.13 ± 4.99 vs. 14.89 ± 14.64, P < 0.05). Systolic (SD) aortic diameters (in mm) were enlarged in obese young patients (25.7 ± 2.8 vs. 27.1 ± 2.5, P < 0.05) and obese old subjects (28.0 ± 3.0 vs. 30.3 ± 3.3, P < 0.05). Diastolic (DD) aortic diameter (in mm) showed similar tendency in youngs (22.8 ± 2.9 vs. 24.9 ± 2.5, P < 0.05) and old subjects (25.9 ± 2.7 vs. 28.0 ± 3.1, P < 0.05).

Conclusions

Aortic stiffness is higher in young obese patients and similar to older subjects without obesity. Both SD and DD are increasing with age, but subjects within similar age group have larger SD and DD suggesting early vascular remodelling in obesity.

Kurth T, Gaziano JM, Berger K et al (2002) Body mass index and the risk of stroke in men. Arch Intern Med 162:2557–2562PubMedCrossRef

Wilson PW, D’Agostino RB, Sullivan L et al (2002) Overweight and obesity as determinants of cardiovascular risk: the Framingham experience. Arch Intern Med 162:1867–1872PubMedCrossRef

Sutton-Tyrrell K, Newman A, Simonsick EM et al (2001) Aortic stiffness is associated with visceral adiposity in older adults enrolled in the study of health, aging, and body composition. Hypertension 38:429–433PubMed

Stefanadis C, Stratos C, Boudoulas H, Kourouklis C, Toutouzas P (1990) Distensibility of the ascending aorta: comparison of invasive and non-invasive techniques in healthy men and in men with coronary artery disease. Eur Heart J 11:990–996PubMed

Nemes A, Caliskan K, Geleijnse ML et al (2007) Alterations in aortic elasticity in noncompaction cardiomyopathy. Int J Cardiovasc Imag (in press)

WHO. (1998) Obesity: preventing and managing the global epidemic: report of a WHO consultation of obesity, Geneva, 1997, World Health Organisation. Obes Res 6:51S–210S

Lakka HM, Laaksonen DE, Lakka TA et al (2002) The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men. JAMA 288:2709–2716PubMedCrossRef

Nemes A, Galema TW, Geleijnse ML et al (2007) Aortic valve replacement for aortic stenosis is associated with improved aortic distensibility at long-term follow-up. Am Heart J 153:147–151PubMedCrossRef

Henry WL, DeMaria A, Gramiak R et al (1980) Report of the American Society of Echocardiography Committee on Nomenclature and Standards in Two-dimensional Echocardiography. Circulation 62:212–217PubMed

10.

Pannier B, Guerin AP, Marchais SJ et al (2005) Stiffness of capacitive and conduit arteries: prognostic significance for end-stage renal disease patients. Hypertension 45:592–596PubMedCrossRef

11.

Blacher J, Safar ME, Pannier B et al (2002) Prognostic significance of arterial stiffness measurements in end-stage renal disease patients. Curr Opin Nephrol Hypertens 11:629–634PubMedCrossRef

12.

Nemes A, Forster T, Csanady M, (2007) Impaired coronary flow velocity reserve and aortic distensibility in patients with untreated hypercholesterolemia—an echocardiographic study. Int J Cardiovasc Imaging 23:15–23PubMedCrossRef

13.

Nemes A, Forster T, Csanady M et al (2004) Indices of aortic distensibility and coronary flow velocity reserve in patients with different grades of aortic atherosclerosis. Int J Cardiovasc Imaging 20:271–277PubMedCrossRef

14.

Danias PG, Tritos NA, Stuber M et al (2003) Comparison of aortic elasticity determined by cardiovascular magnetic resonance imaging in obese versus lean adults. Am J Cardiol 91:195–199PubMedCrossRef

15.

Wildman RP, Mackey RH, Bostom A et al (2003) Measures of obesity are associated with vascular stiffness in young and older adults. Hypertension 42:468–473PubMedCrossRef

16.

Mackey RH, Sutton-Tyrrell K, Vaitkevicius PV et al (2002) Correlates of aortic stiffness in elderly individuals: a subgroup of the Cardiovascular Health Study. Am J Hypertens 15:16–23PubMedCrossRef

17.

Wildman RP, Farhat GN, Patel AS et al (2005) Weight change is associated with change in arterial stiffness among healthy young adults. Hypertension 45:187–192PubMedCrossRef

18.

Brunzell JD, Hokanson JE (1999) Dyslipidemia of central obesity and insulin resistance. Diabetes Care 22(Suppl 3):C10–C13PubMed

19.

Stenvinkel P, Bolinder J, Alvestrand A (1992) Effects of insulin on renal haemodynamics and the proximal and distal tubular sodium handling in healthy subjects. Diabetologia 35:1042–1048PubMedCrossRef

20.

Young JB (1988) Effect of experimental hyperinsulinemia on sympathetic nervous system activity in the rat. Life Sci 43:193–200PubMedCrossRef

21.

Ulrich P, Cerami A (2001) Protein glycation, diabetes, and aging. Recent Prog Horm Res 56:1–21PubMedCrossRef

22.

DeFronzo RA, Ferrannini E. (1991) Insulin resistance. A multifaceted syndrome responsible for NIDDM, obesity, hypertension, dyslipidemia, and atherosclerotic cardiovascular disease. Diabetes Care 14:173–194PubMedCrossRef

23.

Kahn BB, Flier JS (2000) Obesity and insulin resistance. J Clin Invest 106:473–481PubMedCrossRef

24.

Arcaro G, Cretti A, Balzano S et al (2002) Insulin causes endothelial dysfunction in humans: sites and mechanisms. Circulation 105:576–582PubMedCrossRef

25.

Egan BM, Lu G, Greene EL (1999) Vascular effects of non-esterified fatty acids: implications for the cardiovascular risk factor cluster. Prostaglandins Leukot Essent Fatty Acids 60:411–420PubMedCrossRef

26.

Weyer C, Yudkin JS, Stehouwer CD et al (2002) Humoral markers of inflammation and endothelial dysfunction in relation to adiposity and in vivo insulin action in Pima Indians. Atherosclerosis 161:233–242PubMedCrossRef

27.

Visser M, Bouter LM, McQuillan GM et al (1999) Elevated C-reactive protein levels in overweight and obese adults. JAMA 282:2131–2135PubMedCrossRef

28.

Schutte R, Huisman HW, Schutte AE et al (2005) Leptin is independently associated with systolic blood pressure, pulse pressure and arterial compliance in hypertensive African women with increased adiposity: the POWIRS study. J Hum Hypertens 19:535–541PubMedCrossRef

Title: Obesity is associated with aortic enlargement and increased stiffness: an echocardiographic study
Authors: Attila Nemes
Henriette Gavallér
Éva Csajbók
Tamás Forster
Miklós Csanády
Publication date: 01-02-2008
Publisher: Springer Netherlands
Published in: The International Journal of Cardiovascular Imaging / Issue 2/2008
Print ISSN: 1569-5794
Electronic ISSN: 1875-8312
DOI: https://doi.org/10.1007/s10554-007-9248-2

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