HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Marfella, R. Articles by Giugliano, D. Search for Related Content PubMed PubMed Citation Articles by Marfella, R. Articles by Giugliano, D. Social Bookmarking                What's this?

Effect of Weight Loss on Cardiac Synchronization and Proinflammatory Cytokines in Premenopausal Obese Women

¹ Department of Geriatrics and Metabolic Diseases, Second University of Naples, Naples, Italy
² Cardiovascular Research Center, Second University of Naples, Naples, Italy
³ Department of Gynecology, Obstetrics and Neonatology, Second University of Naples, Naples, Italy

Address correspondence and reprint requests to Raffaele Marfella, MD, Via Emilio Scaglione, 141 I-80145 Naples, Italy. E-mail: raffaele.marfella{at}unina2.it

OBJECTIVE—Obesity is an important risk factor for heart failure in both women and men. Dyssynchrony between right and left ventricular contraction and relaxation has been identified as an independent predictor of heart failure. We examined the relationship of ventricular synchronization abnormalities with the concentration of proinflammatory cytokines in obese women at baseline and after sustained weight loss.

RESEARCH DESIGN AND METHODS—Echocardiographic parameters of ventricular dyssynchrony, circulating levels of tumor necrosis factor (TNF)-, interleukin (IL)-6, IL-18, and C-reactive protein (CRP) were investigated in 67 healthy, premenopausal obese women and 40 age-matched normal-weight women.

RESULTS—Compared with nonobese women, obese women had increased concentrations of CRP (P < 0.01), TNF- (P < 0.01), IL-6 (P < 0.01), and IL-18 (P < 0.01). Moreover, obese women had a higher myocardial performance index (P < 0.02) and lower transmitral Doppler flow (P < 0.05), pulmonary venous flow analysis (P < 0.02), and ejection fraction (P < 0.05), indicating ventricular dyssynchrony. Concentrations of CRP, TNF-, and IL-6 were related to anthropometric indexes of obesity and to echocardiographic parameters of ventricular dyssynchrony. After 1 year of a multidisciplinary program of weight reduction, obese women lost at least 10% of their original weight. This was associated with reduction of cytokine (P < 0.01) and CRP (P < 0.02) concentrations and with improvement of echocardiographic parameters of ventricular dyssynchrony, which correlated with changes in adiposity, particularly visceral adiposity.

CONCLUSIONS—In obese women, ventricular dyssynchrony correlates with body fat, possibly through inappropriate secretion of cytokines. Weight loss represents a safe method for downregulating the inflammatory state and ameliorating cardiac function in obese women.

Abbreviations: CRP, C-reactive protein • ET, ejection time • HOMA, homeostasis model assessment • ICT, isovolumetric contracting time • IL, interleukin • IRT, isovolumetric relaxation time • MPI, myocardial performance index • PVF, pulmonary vein flow • RV-RT_m, right ventricular relaxation time • TNF, tumor necrosis factor • WHR, waist-to-hip ratio

CiteULike    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				H. Sell, K. Eckardt, A. Taube, D. Tews, M. Gurgui, G. Van Echten-Deckert, and J. Eckel Skeletal muscle insulin resistance induced by adipocyte-conditioned medium: underlying mechanisms and reversibility Am J Physiol Endocrinol Metab, June 1, 2008; 294(6): E1070 - E1077. [Abstract] [Full Text] [PDF]

				M. M. Riordan, E. P. Weiss, T. E. Meyer, A. A. Ehsani, S. B. Racette, D. T. Villareal, L. Fontana, J. O. Holloszy, and S. J. Kovacs The effects of caloric restriction- and exercise-induced weight loss on left ventricular diastolic function Am J Physiol Heart Circ Physiol, March 1, 2008; 294(3): H1174 - H1182. [Abstract] [Full Text] [PDF]

				M. H Rokling-Andersen, J. E Reseland, M. B Veierod, S. A Anderssen, D. R Jacobs Jr, P. Urdal, J.-O. Jansson, and C. A Drevon Effects of long-term exercise and diet intervention on plasma adipokine concentrations Am. J. Clinical Nutrition, November 1, 2007; 86(5): 1293 - 1301. [Abstract] [Full Text] [PDF]

				L. J. Moran, M. Noakes, P. M. Clifton, G. A. Wittert, D. P. Belobrajdic, and R. J. Norman C-Reactive Protein before and after Weight Loss in Overweight Women with and without Polycystic Ovary Syndrome J. Clin. Endocrinol. Metab., August 1, 2007; 92(8): 2944 - 2951. [Abstract] [Full Text] [PDF]

				J-M Gonzalez-Clemente, C Vilardell, M Broch, A Megia, A Caixas, O Gimenez-Palop, C Richart, I Simon, A Martinez-Riquelme, J Arroyo, et al. Lower heart rate variability is associated with higher plasma concentrations of IL-6 in type 1 diabetes Eur. J. Endocrinol., July 1, 2007; 157(1): 31 - 38. [Abstract] [Full Text] [PDF]

				E. Selvin, N. P. Paynter, and T. P. Erlinger The Effect of Weight Loss on C-Reactive Protein: A Systematic Review Arch Intern Med, January 8, 2007; 167(1): 31 - 39. [Abstract] [Full Text] [PDF]

				S. Shadid, C. D. A. Stehouwer, and M. D. Jensen Diet/Exercise Versus Pioglitazone: Effects of Insulin Sensitization with Decreasing or Increasing Fat Mass on Adipokines and Inflammatory Markers J. Clin. Endocrinol. Metab., September 1, 2006; 91(9): 3418 - 3425. [Abstract] [Full Text] [PDF]

				S. Maeda, S. Jesmin, M. Iemitsu, T. Otsuki, T. Matsuo, K. Ohkawara, Y. Nakata, K. Tanaka, K. Goto, and T. Miyauchi Weight loss reduces plasma endothelin-1 concentration in obese men. Experimental Biology and Medicine, June 1, 2006; 231(6): 1044 - 1047. [Abstract] [Full Text] [PDF]

				A. E Malavazos, E. Cereda, L. Morricone, C. Coman, M. M Corsi, and B. Ambrosi Monocyte chemoattractant protein 1: a possible link between visceral adipose tissue-associated inflammation and subclinical echocardiographic abnormalities in uncomplicated obesity Eur. J. Endocrinol., December 1, 2005; 153(6): 871 - 877. [Abstract] [Full Text] [PDF]

				B. J. Nicklas, T. You, and M. Pahor Behavioural treatments for chronic systemic inflammation: effects of dietary weight loss and exercise training Can. Med. Assoc. J., April 26, 2005; 172(9): 1199 - 1209. [Abstract] [Full Text] [PDF]

				S. Klein, L. E. Burke, G. A. Bray, S. Blair, D. B. Allison, X. Pi-Sunyer, Y. Hong, and R. H. Eckel Clinical Implications of Obesity With Specific Focus on Cardiovascular Disease: A Statement for Professionals From the American Heart Association Council on Nutrition, Physical Activity, and Metabolism: Endorsed by the American College of Cardiology Foundation Circulation, November 2, 2004; 110(18): 2952 - 2967. [Abstract] [Full Text] [PDF]