1. Sex-specific associations of obesity with exercise capacity and diastolic function in Koreans.
- Author
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Jung MH, Ihm SH, Lee DH, Han S, Jung HO, Youn HJ, and Ryu KH
- Subjects
- Adult, Aged, Cross-Sectional Studies, Diastole, Female, Health Status Disparities, Heart Failure diagnostic imaging, Heart Failure epidemiology, Humans, Male, Middle Aged, Obesity diagnosis, Obesity epidemiology, Republic of Korea epidemiology, Risk Assessment, Risk Factors, Sex Factors, Ventricular Dysfunction, Left diagnostic imaging, Ventricular Dysfunction, Left epidemiology, Young Adult, Exercise Tolerance, Heart Failure physiopathology, Obesity physiopathology, Ventricular Dysfunction, Left physiopathology, Ventricular Function, Left
- Abstract
Background and Aims: Women with obesity are highly predominant among patients with heart failure with preserved ejection fraction (HFpEF). We aimed to elucidate sex-specific associations of obesity with exercise capacity and diastolic function., Methods and Results: Healthy individuals without known cardiovascular diseases undergoing cardiopulmonary exercise test and echocardiography (n = 736) were included and categorized into 4 groups according to their sex and obesity. Exercise capacity was lower in women than men. Obesity was associated with a lower exercise capacity in women (23.5 ± 7.3 vs. 21.3 ± 5.4 ml/kg/min, p < 0.05) but not in men (28.2 ± 7.8 vs. 28.0 ± 6.6 ml/kg/min, p > 0.10). Overall, women had a higher E/e' than men. Women without obesity had a similar E/e' to men with obesity (8.2 ± 1.8 vs. 8.4 ± 2.1, p > 0.10), and women with obesity had the highest E/e'. Among 5 risk factors (aging, obesity, elevated blood pressure, elevated heart rate, and elevated fasting glucose), obesity was a significant determinant of exercise intolerance in women but not men. Furthermore, obesity was associated with a greater risk of diastolic dysfunction in women than men (women, adjusted odds ratio 4.35 [95% confidence interval 2.44-7.74]; men, adjusted odds ratio 2.91 [95% confidence interval 1.42-5.95])., Conclusion: Obesity had a more deleterious effect on exercise capacity and diastolic function in women than men, even in a healthy cohort. These subclinical changes might contribute to the development of a female predominance among HFpEF patients, particularly among individuals with obesity., (Copyright © 2020 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.)
- Published
- 2021
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