Early Detection of Myocardial Work Impairment in Obesity II(EARLY-MYO-OBESITY-II)

Study Overview
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Brief Summary
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This prospective study intends to explore the change of cardiac structure and function in the cohort of overweight or obesity patients, and determine the impact of clinical characteristics on cardiac remodeling and mechanics.

Detailed Description
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Obesity significantly increases the risk for heart failure. Early detection of preclinical cardiac dysfunction in overweight or obesity and understanding its association with insulin resistance are of great importance.Recently, a novel technique for myocardial work (MW) assessment has been introduced to evaluate myocardial performance. To date, change of MW has been described in several cardiac conditions including dilated cardiomyopathy, significant coronary arterial diseases, and hypertrophic cardiomyopathy, which implies regional or global myocardial dysfunction. In this study, we aimed to explore the alteration of MW in overweight or obese adults and to determine whether insulin resistance or other clinical risk factors may impact myocardial mechanics before impairment of systolic function.

Official Title
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Early Detection of Myocardial Work Impairment in Patients With Overweight and Obesity (EARLY-MYO-OBESITY-II)

Conditions
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Overweight and Obesity

Intervention / Treatment
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* Diagnostic Test: Myocardial work was estimated from left ventricular pressure-strain loop derived from speckle tracking echocardiography and non-invasive brachial artery cuff pressure


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All patients were older than 18 without any cardiac symptoms. The diagnosis of overweight was established when body mass index (BMI) of 25 to 30 kg/m2. Obese was defined as a BMI of 30 kg/m2 or higher. Exclusion Criteria: diagnosis of type 2-Diabetes Mellitus according to the American Diabetes Association criteria; left ventricular ejection fraction<50% on echocardiography; arrythmia on electrocardiogram; severe valvular stenosis or regurgitation; history of coronary disease (defined as stenosis>50%) or myocardial infarction; stress induced wall motion abnormality on echocardiography, coronary artery stenosis >50% on coronary CT or angiography with Framingham risk score of >10; pacemaker or defibrillator implantation; the presence of bundle branch block; severe infection or renal dysfunction with an estimated glomerular filtration rate < 60 ml/min/1.73 m2); inadequate image quality on echocardiography.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 70 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| control<br>Lean health controls with a BMI<25kg/m2 | Diagnostic Test: Myocardial work was estimated from left ventricular pressure-strain loop derived from speckle tracking echocardiography and non-invasive brachial artery cuff pressure<br>* Baseline and follow-up examination of echocardiography is to be performed on study subjects.<br>|
| overweight<br>patients with a BMI of 25-30kg/m2 | Diagnostic Test: Myocardial work was estimated from left ventricular pressure-strain loop derived from speckle tracking echocardiography and non-invasive brachial artery cuff pressure<br>* Baseline and follow-up examination of echocardiography is to be performed on study subjects.<br>|
| obesity<br>patients with a BMI of over 30kg/m2 | Diagnostic Test: Myocardial work was estimated from left ventricular pressure-strain loop derived from speckle tracking echocardiography and non-invasive brachial artery cuff pressure<br>* Baseline and follow-up examination of echocardiography is to be performed on study subjects.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| investigate the change of global myocardial work index (GWI) in overweight or obese patients | GWI derived from echocardiography will be assessed in overweight or obese patients and compare with lean controls | within 24 hours of the recruitment | 
| investigate the change of global constructive work (GCW) in overweight or obese patients | GCW will be assessed in overweight or obese patients and compare with lean controls | within 24 hours of the recruitment | 
| investigate the change of global waste work (GWW) in overweight or obese patients | GWW will be assessed in overweight or obese patients and compare with lean controls | within 24 hours of the recruitment | 
| investigate the change of global work efficiency (GWE) in overweight or obese patients | GWE will be assessed in overweight or obese patients and compare with lean controls | within 24 hours of the recruitment |