The Relationships between Body Mass Index and Left Ventricular Diastolic Function in a Structurally Normal Heart with Normal Ejection Fraction.

Background: We conducted research to determine the effect of the weight on left ventricular (LV) diastolic function in Asians, who are at greater risk of cardiovascular events compared to individuals from Western countries with similar body mass indices (BMIs).

Methods: We studied 543 participants with structurally normal hearts and normal ejection fractions. Participants were classified as normal-weight (BMI < 23.0 kg/m²), overweight (BMI 23.0-27.4 kg/m²), or obese (BMI ≥ 27.5 kg/m²). Peak E velocity, peak A velocity, and E' velocity were measured and E/E' was calculated.

Results: Overweight participants had lower E than normal-weight participants (p = 0.001). E' velocities in overweight and obese participants were less than those in normal weight participants (both p < 0.001). The E/E' ratio in obese participants was higher compared to the value in normal-weight participants (p < 0.001) and overweight participants (p = 0.025). BMI was associated with E (R = -0.108), A (R = 0.123), E' (R = -0.229), and E/E' ratio (R = 0.138) (all p < 0.05). In multivariate analyses, BMI was independently associated with higher A, lower E', and higher E/E'. The risk of diastolic dysfunction was significantly higher among overweight [adjusted odds ratio: 2.088; 95% confidence interval (CI): 1.348-3.235; p = 0.001] and obese participants (adjusted odds ratio: 5.910; 95% CI: 2.871-12.162; p < 0.001) compared to normal-weight participants.

Conclusion: Obesity and overweight independently predicted diastolic dysfunction. An optimal body weight lower than the universal cut-off is reasonable for preventing LV heart failure in Asians.