Analysis of myocardial work in different obesity phenotypes and its association with epicardial adipose tissue.
4 affiliations
- 1Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510145, China.
- 2Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai, China.
- 3Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510145, China. [email protected].
- 4Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510145, China. [email protected].
Abstract
Objective
To evaluate subclinical cardiac dysfunction across distinct obesity phenotypes using myocardial work (MW) indices, and to investigate the moderating role of epicardial adipose tissue (EAT) on MW impairment.Methods
One hundred ninety-two participants were categorized by BMI and metabolic status into four groups: metabolically healthy normal weight (MHNW), metabolically healthy obesity (MHO), metabolically unhealthy normal weight (MUNW), and metabolically unhealthy obesity (MUO). MW indices were measured using speckle-tracking echocardiography. EAT volume was quantified from ECG-gated CT scans. Associations were analyzed using ANCOVA and regression models.Results
Despite no significant differences in left ventricular ejection fraction (LVEF) among the groups, MUNW and MUO individuals exhibited significantly impaired MW, characterized by lower global work index (GWI), global constructive work (GCW), and global work efficiency (GWE), alongside higher global waste work (GWW), compared with MHNW controls. MHO patients showed significantly better MW profiles than MUNW and MUO groups. EAT volume was increased in all obesity phenotype groups. Although no direct association was found between EAT volume and MW indices, EAT volume significantly moderated the relationship between Metabolically Unhealthy (MUH) and both GWE and GWW.Conclusions
MW detects subclinical dysfunction earlier than LVEF across obesity phenotypes, with impairment progressively worsening from MHO to MUNW to MUO. In metabolically unhealthy individuals with increased EAT volume, more pronounced reductions in GWE and elevations in GWW were observed.Trial rrgistration
This study has been registered in the Chinese Clinical Trial Registry under the registration number ChiCTR2500100754 (registration date: April 15, 2025).
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BibTeX
@article{wang2026analysis,
title = {{Analysis of myocardial work in different obesity phenotypes and its association with epicardial adipose tissue.}},
author = {Zhenjiang Wang and Chaodi Tan and Zhuoxin Lyu and Zhuzhi Wen and Tao Wu and Dengfeng Geng and Shaoxin Zheng},
journal = {BMC cardiovascular disorders},
year = {2026},
month = jul,
doi = {10.1186/s12872-026-06298-3},
url = {https://europepmc.org/article/MED/42894112},
note = {CC BY},
}
RIS
TY - JOUR
TI - Analysis of myocardial work in different obesity phenotypes and its association with epicardial adipose tissue.
AU - Zhenjiang Wang
AU - Chaodi Tan
AU - Zhuoxin Lyu
AU - Zhuzhi Wen
AU - Tao Wu
AU - Dengfeng Geng
AU - Shaoxin Zheng
PY - 2026
DA - 2026/07/01
JO - BMC cardiovascular disorders
DO - 10.1186/s12872-026-06298-3
UR - https://europepmc.org/article/MED/42894112
AB - Objective To evaluate subclinical cardiac dysfunction across distinct obesity phenotypes using myocardial work (MW) indices, and to investigate the moderating role of epicardial adipose tissue (EAT) on MW impairment.Methods One hundred ninety-two participants were categorized by BMI and metabolic status into four groups: metabolically healthy normal weight (MHNW), metabolically healthy obesity (MHO), metabolically unhealthy normal weight (MUNW), and metabolically unhealthy obesity (MUO). MW indices were measured using speckle-tracking echocardiography. EAT volume was quantified from ECG-gated CT scans. Associations were analyzed using ANCOVA and regression models.Results Despite no significant differences in left ventricular ejection fraction (LVEF) among the groups, MUNW and MUO individuals exhibited significantly impaired MW, characterized by lower global work index (GWI), global constructive work (GCW), and global work efficiency (GWE), alongside higher global waste work (GWW), compared with MHNW controls. MHO patients showed significantly better MW profiles than MUNW and MUO groups. EAT volume was increased in all obesity phenotype groups. Although no direct association was found between EAT volume and MW indices, EAT volume significantly moderated the relationship between Metabolically Unhealthy (MUH) and both GWE and GWW.Conclusions MW detects subclinical dysfunction earlier than LVEF across obesity phenotypes, with impairment progressively worsening from MHO to MUNW to MUO. In metabolically unhealthy individuals with increased EAT volume, more pronounced reductions in GWE and elevations in GWW were observed.Trial rrgistration This study has been registered in the Chinese Clinical Trial Registry under the registration number ChiCTR2500100754 (registration date: April 15, 2025).
SN - 1471-2261
ER -