Left ventricle hypertrophy due to systemic arterial hypertension in severe obesity: electrocardiographic study

Abstract

Obesity is a multifactorial disease in which is verified a pathologic increase of adipose tissue associated with a low intensity chronic inflammatory state. Obesity is considered a worldwide epidemic disorder and represents one of the major challenges in public health due to its increase in prevalence and incidence, besides many complications and comorbidities associated. The systemic arterial hypertension (SAH) is one of the main comorbidities associated with obesity, 50% more prevalent in obese people. The left ventricular hypertrophy (LVH) is an extremely important risk factor for cardiovascular morbidity and mortality and it is the center of many studies that correlate the cardiac hypertrophy with hypertension and with obesity. In the preoperative care assessment of morbid obese patients the electrocardiogram and echocardiography are recommended as routine exams. The electrocardiogram (ECG) is extensively used to assess the cardiac effects of SAH (Systemic Arterial Hypertension). The left ventricular hypertrophy (LVH) is considered a risk factor for developing congestive heart failure (HF), ventricular arrhythmias and premature death. The obesity is also associated with thickness of the left ventricle, premature death and disability due to cardiovascular disease, with possibility of regression after bariatric surgery. Recent meta-analysis data has shown that still there is no established criteria to foresee left ventricular hypertrophy in severe obesity with systemic arterial hypertension, even though the electrocardiogram reveals abnormalities in LVH. Therefore, the target of this study is evaluate the best electrocardiographic criterion (or combination of electrocardiographic criteria) to diagnose the LVH by echocardiography in severely obese patients with arterial hypertension.