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Review
. 2020 Jan 21;9(2):e014609.
doi: 10.1161/JAHA.119.014609. Epub 2020 Jan 9.

Echocardiographic Imaging Challenges in Obesity: Guideline Recommendations and Limitations of Adjusting to Body Size

Maninder Singh  1   2 , Anuradha Sethi  3 , Abhishek K Mishra  1 , Navin K Subrayappa  1 , Dwight D Stapleton  4 , Patricia A Pellikka  5
Affiliations
Review

Echocardiographic Imaging Challenges in Obesity: Guideline Recommendations and Limitations of Adjusting to Body Size

Maninder Singh et al. J Am Heart Assoc. .
No abstract available

Keywords: body mass index; echocardiography; obesity.

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Figures

Figure 1
Figure 1
Imaging pitfalls in obese individuals. A, Illustration showing discrepancies in assessment of LA volume, diastolic function, and LVH assessment in a lean vs obese patient of similar height. BMI indicates body mass index; BSA, body surface area (Mosteller formula); i, indexed; IVDd, internal left ventricular diameter in diastole; IVS, interventricular septum; LA, left atrial; LV, left ventricle; LVH, left ventricular hypertrophy; PW, posterior wall; TRV, tricuspid regurgitant velocity. B, Illustration showing discrepancies in assessment of aortic stenosis, flow state, and assessment of PPM in a lean vs an obese patient of similar height. AVA indicates aortic valve area; BMI, body mass index; BSA, body surface Area; EOA, effective orifice area; i, indexed; MG, mean gradient; PPM, patient prosthesis mismatch; PV, peak velocity; SV, Stroke Volume. In echocardiograms: e′ indicates Mitral Annular Tissue Doppler Velocity; E/A, Ratio of E wave and A wave; E/e′, Ratio of E wave to mitral annular velocity; LVOT, LV outflow tract; VTI, Velocity Time Integral.
Figure 2
Figure 2
Proposed indexing methods for chamber quantification in obese individuals. A schematic showing proposed alternative indexing methods for obese individuals to avoid misclassification. 2D indicates 2‐dimensional; abn, abnormal; AVA, aortic valve area; BMI, body mass index; BSA, body surface area; LVOT, left ventricular outflow tract; SVi, Stroke Volume (indexed); SV, stroke volume.
Figure 3
Figure 3
Myocardial adaptations in obesity. Illustration showing some of the physiological and pathological myocardial adaptations relevant to indexing in obese individuals. LA indicates left atrium; LV, left ventricle; ↑, increase.
See this image and copyright information in PMC

References

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