Cardiology Research, ISSN 1923-2829 print, 1923-2837 online, Open Access
Article copyright, the authors; Journal compilation copyright, Cardiol Res and Elmer Press Inc
Journal website http://www.cardiologyres.org

Original Article

Volume 10, Number 3, June 2019, pages 165-171


Patients With Obesity Exhibit a Plateau Pattern of the Right Ventricular Waveform

Figures

Figure 1.
Figure 1. Measurement of the EAT using echocardiography. EAT was detected as an echo-free space between the outer wall of the right ventricle and visceral layer of the pericardium during the end-diastolic cardiac cycle (double arrow). Ao: aorta; EAT: epicardial adipose tissue; LA: left atrium; LV: left ventricle; RV: right ventricle.
Figure 2.
Figure 2. A representative plateau pattern of the right ventricular waveform.
Figure 3.
Figure 3. (a) The EAT values in the patients who exhibited a plateau pattern (w/plateau) are significantly higher than those in the patients who did not (w/o plateau). (b) The mean BMI values are higher in the patients with a plateau than in those without it. (c) Scatter plots between the EAT and BMI. BMI: body mass index; EAT: epicardial adipose tissue.
Figure 4.
Figure 4. (a) The TG levels in the patients who exhibited a plateau pattern (w/plateau) are significantly higher than in those who did not (w/o plateau). (b) The LDL-C levels in the patients with a plateau are significantly higher than those in the patients without a plateau. (c) Scatter plots between the TG level and EAT. (d) Scatter plots between the TG level and BMI. BMI: body mass index; EAT: epicardial adipose tissue; LDL-C: low-density lipoprotein cholesterol; TG: triglyceride.
Figure 5.
Figure 5. (a) The left atrial diameter is significantly larger in the patients with a plateau pattern (w/plateau) than in those without it (w/o plateau). (b) The left atrial volume index is significantly higher in the patients with a plateau pattern than in those without it.

Tables

Table 1. Comparison of the Clinical and Laboratory Characteristics of Patients Without and With a Plateau Pattern
 
Without a plateau (n = 49)With a plateau (n = 11)P value
Data are expressed as the mean ± SD or n (%). BMI: body mass index; BP: blood pressure; EAT: epicardial adipose tissue; HbA1c: glycated hemoglobin; HDL-C: high-density lipoprotein cholesterol; LDL-C: low-density lipoprotein cholesterol; PPG: postprandial plasma glucose; TC: total cholesterol; TG: triglyceride.
Age (years)69.3 ± 13.469.9 ± 16.80.90
Male28 (57%)5 (45%)0.52
Weight (kg)55.5 ± 12.269.0 ± 14.2< 0.01
Height (m)1.58 ± 0.091.59 ± 0.080.89
BMI (kg/m2)21.8 ± 3.627.2 ± 5.7< 0.001
EAT (mm)2.19 ± 1.974.26 ± 3.13< 0.01
Systolic BP (mm Hg)129.2 ± 23.5133.2 ± 23.00.61
Diastolic BP (mm Hg)67.7 ± 13.676.7 ± 16.00.06
Heart rate (beats/min)70.8 ± 14.373.6 ± 15.10.56
TC (mg/dL)170.3 ± 42.2196.2 ± 47.90.08
HDL-C (mg/dL)57.7 ± 18.551.1 ± 27.30.34
LDL-C (mg/dL)95.8 ± 34.1121.8 ± 35.6< 0.05
TG (mg/dL)100.2 ± 67.9150.4 ± 82.6< 0.05
HbA1c (%)6.4 ± 1.596.2 ± 0.770.75
PPG (mg/dL)126 ± 62.8120 ± 27.90.79

 

Table 2. Comparison of the Right Cardiac Catheterization Characteristics of Patients Without and With a Plateau Pattern
 
Without a plateau (n = 49)With a plateau (n = 11)P value
Data are expressed as the mean ± SD. PA: pulmonary artery; PCWP: pulmonary capillary wedge pressure; RA: right atrium; RV: right ventricle.
Cardiac output (L/min)4.93 ± 1.375.18 ± 1.730.61
Cardiac index (L/min/m2)3.21 ± 0.942.97 ± 0.820.46
Main PA systolic pressure (mm Hg)33.5 ± 12.835.7 ± 10.10.63
Main PA diastolic pressure (mm Hg)15.9 ± 7.1916.3 ± 6.50.88
Main PA mean pressure (mm Hg)23.0 ± 9.5123.8 ± 9.110.81
Right PA systolic pressure (mm Hg)33.3 ± 12.435.7 ± 10.00.56
Right PA diastolic pressure (mm Hg)16.4 ± 7.1115.7 ± 6.880.75
Right PA mean pressure (mm Hg)22.9 ± 9.3923.7 ± 9.180.79
Mean PCWP (mm Hg)14.4 ± 7.6114.3 ± 6.630.96
RV systolic pressure (mm Hg)33.0 ± 11.733.2 ± 10.90.94
RV diastolic pressure (mm Hg)5.67 ± 4.394.54 ± 2.200.41
RV end-diastolic pressure (mm Hg)9.00 ± 4.079.18 ± 3.680.89
Mean RA (mm Hg)6.59 ± 3.856.81 ± 3.060.85

 

Table 3. Comparison of the Echocardiographic Characteristics of Patients Without and With a Plateau Pattern
 
Without a plateau (n = 49)With a plateau (n = 11)P value
Data are expressed as the mean ± SD. DT: mitral deceleration time; e’: mitral annulus early peak velocity; EF: ejection fraction; IVC ex: inferior vena cava expiration; IVC in: inferior vena cava inspiration; IVCCI: IVC collapsibility index; IVSd: interventricular septum diameter; LAD: left atrial diameter; LAVI: left atrial volume index; LVDd: left ventricular end-diastolic diameter; LVDs: left ventricular end-systolic diameter; LVMI: left ventricular mass index; PWd: posterior wall diameter; RWT: relative wall thickness.
LVDd (mm)51.2 ± 9.8748.5 ± 8.530.40
LVDs (mm)37.8 ± 12.235.0 ± 10.60.48
IVSd (mm)10.9 ± 2.1611.4 ± 1.170.42
PWd (mm)10.4 ± 1.9211.1 ± 0.500.27
EF (%)49.4 ± 20.550.1 ± 19.50.91
LVMI (g/m2)141.4 ± 70.6115.7 ± 32.90.26
RWT0.435 ± 0.0960.476 ± 0.0690.21
E/A ratio1.28 ± 0.691.60 ± 0.920.40
DT (ms)187.5 ± 60.4173.0 ± 48.00.52
e’ (cm/s)5.66 ± 2.167.15 ± 1.810.11
E/e’ (ratio)16.3 ± 7.9516.5 ± 6.140.95
LAD (mm)44.7 ± 8.6952.8 ± 4.30< 0.01
LAVI (mL/m2)47.6 ± 14.958.7 ± 12.1< 0.05
IVC ex (mm)15.8 ± 4.6817.8 ± 6.750.25
IVC in (mm)6.87 ± 4.9910.0 ± 8.490.09
IVCCI58.9 ± 20.150.2 ± 24.90.25