Cardiac Systolic and Diastolic Function can be Improved and Epicardial Fat be can Decreased Over a Very Short Period of Time in Obese Patients without Heart Disease by the Very Low Calorie Diet

The objective of the study was to evaluate the effect of an eight week period of very low calorie diet (VLCD) on heart function and amount of epicardial adipose tissue in obese people without heart disease. Methods: Fifty-two obese patients (38 women, 14 men, mean age 47.6 ± 12.3 years, mean BMI 46.2±7.0 kg/m2) were assigned to a VLCD enriched with vegetables for eight weeks. Transthoracic echocardiography was performed before and after the diet period. Left ventricular size, ejection fraction, diastolic function, left and right ventricular myocardial performance index (MPI) and thickness of epicardial adipose tissue were measured. Heart rate, blood pressure and plasma glucose and triglyceride concentration were also analysed. Results: During the diet period the BMI decreased from 46.2±7.0 kg/m2 to 41.8± 6.1 kg/m2 (p<0.0001). The left ventricular MPI decreased from 0.42± 0.07 to 0.37± 0.07 (p<0.0001) and right ventricular MPI decreased from 0.30± 0.09 to 0.27± 0.09 (p=0.0256) showing significant systolic and diastolic improvement in the performance of both ventricles. The thickness of epicardial fat decreased from 4.4±1.5 mm to 3.4±1.4 mm (p<0.0001). The heart rate decreased from 75.8±9.7 beats/min to 67.0 ±10.3 beats/min (p<0.0001) and the systolic blood pressure decreased from 140±14.3 mmHg to 135.2±10.6 mmHg (p=0.0087). The plasma glucose concentration decreased from 6.71±1.96 mmol/l to 6.02±1.59 mmol/l (p<0.0001). The plasma triglyceride concentration decreased from 1.77±0.89 mmol/l to 1.36±0.68 mmol/l (p=0.0002). Conclusion: VLCD caused during only eight weeks period significant reduction in BMI as well as in the amount of epicardial fat and significant improvement in the systolic and diastolic function of both ventricles in obese persons.