Differential Cardiac Remodeling in Overweight and Obesity: Insights from Noninvasive Imaging

Introduction: Weight gain is associated with cardiac abnormalities, but the differences in cardiac remodeling between overweight and obesity (O&O) remain unclear. This study explored the structural and functional cardiac changes associated with O&O using noninvasive imaging. Methods: A retrospective study included participants from August 2021 to July 2023. Clinical data, laboratory results, and echocardiography reports were collected, and cardiac magnetic resonance imaging was post-processed. Cardiac structural and functional parameters were compared among healthy weight, overweight, and obesity groups, and their relationships with body mass index (BMI) were analyzed. Results: A total of 275 participants were included. Significant differences in left ventricular end-diastolic/systolic diameters, left atrial diameter, left ventricular ejection fraction, and stroke volume index were observed between O&O and healthy weight groups (p < 0.05). However, no significant differences were found between the O&O groups in terms of left ventricular septum thickness, left ventricular posterior wall thickness, cardiac index, or end-systolic volume index (p > 0.05). Multivariable regression showed a positive correlation between BMI and cardiac structural/ functional indicators (p < 0.05), with greater changes in obesity. Loess spline analysis revealed that cardiac remodeling was more pronounced during the overweight stage. Conclusions: Both O&O are associated with larger cardiac dimensions, increased myocardial mass, and impaired function. Cardiac remodeling accelerates during the overweight stage, emphasizing the need for early detection and intervention in overweight individuals to mitigate future health risks.