Skip to main content
Log in

Cardiac function and arteriovenous oxygen difference during exercise in obese adults

  • Original Article
  • Published:
European Journal of Applied Physiology Aims and scope Submit manuscript

Abstract

The purpose of this study was to assess cardiac function and arteriovenous oxygen difference (a-vO2 difference) at rest and during exercise in young, normal-weight (n = 20), and obese (n = 12) men and women who were matched for age and fitness level. Participants were assessed for body composition, peak oxygen consumption (VO2peak), and cardiac variables (thoracic bioimpedance)—cardiac index (CI), cardiac output (Q), stroke volume (SV), heart rate (HR), and ejection fraction (EF)—at rest and during cycling exercise at 65% of VO2peak. Differences between groups were assessed with multivariate ANOVA and mixed-model ANOVA with repeated measures controlling for sex. Absolute VO2peak and VO2peak relative to fat-free mass (FFM) were similar between normal-weight and obese groups (Mean ± SEE 2.7 ± 0.2 vs. 3.3 ± 0.3 l min−1, p = 0.084 and 52.4 ± 1.5 vs. 50.9 ± 2.3 ml kg FFM−1 min−1, p = 0.583, respectively). In the obese group, resting Q and SV were higher (6.7 ± 0.4 vs. 4.9 ± 0.1 l min−1, p < 0.001 and 86.8 ± 4.3 vs. 65.8 ± 1.9 ml min−1, p < 0.001, respectively) and EF lower (56.4 ± 2.2 vs. 65.5 ± 2.2%, p = 0.003, respectively) when compared with the normal-weight group. During submaximal exercise, the obese group demonstrated higher mean CI (8.8 ± 0.3 vs. 7.7 ± 0.2 l min−1 m−2, p = 0.007, respectively), Q (19.2 ± 0.9 vs. 13.1 ± 0.3 l min−1, p < 0.001, respectively), and SV (123.0 ± 5.6 vs. 88.9 ± 4.1 ml min−1, p < 0.001, respectively) and a lower a-vO2 difference (10.4 ± 1.0 vs. 14.0 ± 0.7 ml l00 ml−1, p = 0.002, respectively) compared with controls. Our study suggests that the ability to extract oxygen during exercise may be impaired in obese individuals.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  • Alaud-din A, Meterissian S, Lisbona R, MacLean LD, Forse RA (1990) Assessment of cardiac function in patients who were morbidly obese. Surgery 108:809–818

    PubMed  CAS  Google Scholar 

  • Artham SM, Lavie CJ, Patel HM, Ventura HO (2008) Impact of obesity on the risk of heart failure and its prognosis. J Cardiometab Syndr 3:155–161

    Google Scholar 

  • Baldi JC, Aoina JL, Oxenham HC, Bagg W, Doughty RN (2003) Reduced exercise arteriovenous O2 difference in Type 2 diabetes. J Appl Physiol 94:1033–1038

    Google Scholar 

  • Charloux A, Lonsdorfer-Wolf E, Richard R, Lampert E, Oswald-Mammosser M, Mettauer B, Geny B, Lonsdorfer J (2000) A new impedance cardiograph device for the non-invasive evaluation of cardiac output at rest and during exercise: comparison with the “direct” Fick method. Eur J Appl Physiol 82:313–320

    Article  PubMed  CAS  Google Scholar 

  • de Divitiis O, Fazio S, Petitto M, Maddalena G, Contaldo F, Mancini M (1981) Obesity and cardiac function. Circulation 64:477–482

    Google Scholar 

  • DuBois D, DuBois EF (1916) A formula to estimate the approximate surface area if height and weight be known. Arch Intern Medicine 17:863–871

    CAS  Google Scholar 

  • Feldschuh J, Enson Y (1977) Prediction of the normal blood volume. Relation of blood volume to body habitus. Circulation 56:605–612

    PubMed  CAS  Google Scholar 

  • Ferraro S, Perrone-Filardi P, Desiderio A, Betocchi S, D’Alto M, Liguori L, Trimigliozzi P, Turco S, Chiariello M (1996) Left ventricular systolic and diastolic function in severe obesity: a radionuclide study. Cardiology 87:347–353

    Article  PubMed  CAS  Google Scholar 

  • Fletcher GF, Balady GJ, Amsterdam EA, Chaitman B, Eckel R, Fleg J, Froelicher VF, Leon AS, Pina IL, Rodney R, Simons-Morton DA, Williams MA, Bazzarre T (2001) Exercise standards for testing and training: a statement for healthcare professionals from the American Heart Association. Circulation 104:1694–1740

    Article  PubMed  CAS  Google Scholar 

  • Frohlich ED (1991) Obesity and hypertension. Hemodynamic aspects. Ann Epidemiol 1:287–293

    Article  PubMed  CAS  Google Scholar 

  • Garn SM, Clark DC (1975) Hemoglobin and fatness. Ecol Food Nutr 4:131–133

    Article  CAS  Google Scholar 

  • Garn SM, Ryan AS (1982) The effect of fatness on hemoglobin levels. Am J Clin Nutr 36:189–192

    PubMed  CAS  Google Scholar 

  • Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, Gordon DJ, Krauss RM, Savage PJ, Smith Jr SC, Spertus JA, Costa F (2005) Diagnosis and management of the metabolic syndrome. An American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Executive summary. Cardiol Rev 13:322–327

    Google Scholar 

  • Lemmens HJ, Bernstein DP, Brodsky JB (2006) Estimating blood volume in obese and morbidly obese patients. Obes Surg 16:773–776

    Article  PubMed  Google Scholar 

  • Melanson KJ, McInnis KJ, Rippe JM, Blackburn G, Wilson PF (2001) Obesity and cardiovascular disease risk: research update. Cardiol Rev 9:202–207

    Google Scholar 

  • Messerli FH, Ventura HO, Reisin E, Dreslinski GR, Dunn FG, MacPhee AA, Frohlich ED (1982) Borderline hypertension and obesity: two prehypertensive states with elevated cardiac output. Circulation 66:55–60

    PubMed  CAS  Google Scholar 

  • National Heart Lung Blood Institute (1997) The Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. 98-4080

  • Palmieri V, Russo C, Palmieri EA, Arezzi E, Pezzullo S, Minichiello S, Martino S, Migliaresi P, Celentano A (2006) Isolated left ventricular diastolic dysfunction: implications for exercise left ventricular performance in patients without congestive heart failure. J Am Soc Echocardiogr 19:491–498

    Article  PubMed  Google Scholar 

  • Peterson LR, Waggoner AD, Schechtman KB, Meyer T, Gropler RJ, Barzilai B, Davila-Roman VG (2004) Alterations in left ventricular structure and function in young healthy obese women: assessment by echocardiography and tissue Doppler imaging. J Am Coll Cardiol 43:1399–1404

    Google Scholar 

  • Poirier P, Giles TD, Bray GA, Hong Y, Stern JS, Pi-Sunyer FX, Eckel RH, American Heart Association, Obesity Committee of the Council on Nutrition, Physical Activity, and Metabolism (2006) Obesity and cardiovascular disease: pathophysiology, evaluation, and effect of weight loss: an update of the 1997 American Heart Association Scientific Statement on Obesity and Heart Disease from the Obesity Committee of the Council on Nutrition, Physical Activity, and Metabolism. Circulation 113:898–918

    Google Scholar 

  • Powell BD, Redfield MM, Bybee KA, Freeman WK, Rihal CS (2006) Association of obesity with left ventricular remodeling and diastolic dysfunction in patients without coronary artery disease. Am J Cardiol 98:116–120

    Google Scholar 

  • Richard R, Lonsdorfer-Wolf E, Charloux A, Doutreleau S, Buchheit M, Oswald-Mammosser M, Lampert E, Mettauer B, Geny B, Lonsdorfer J (2001) Non-invasive cardiac output evaluation during a maximal progressive exercise test, using a new impedance cardiograph device. Eur J Appl Physiol 85:202–207

    Article  PubMed  CAS  Google Scholar 

  • Robergs RA, Dwyer D, Astorino T (2010) Recommendations for improved data processing from expired gas analysis indirect calorimetry. Sports Med 40:95–111

    Article  PubMed  Google Scholar 

  • Rowland T, Bhargava R, Parslow D, Heptulla RA (2003) Cardiac response to progressive cycle exercise in moderately obese adolescent females. J Adolesc Health 32:422–427

    Google Scholar 

  • Salvadori A, Fanari P, Fontana M, Buontempi L, Saezza A, Baudo S, Miserocchi G, Longhini E (1999) Oxygen uptake and cardiac performance in obese and normal subjects during exercise. Respiration 66:25–33

    Google Scholar 

  • Schuster I, Karpoff L, Perez-Martin A, Oudot C, Startun A, Rubini M, Obert P, Vinet A (2009) Cardiac function during exercise in obese prepubertal boys: effect of degree of obesity. Obesity (Silver Spring) 17:1878–1883

  • Stepniakowski K, Egan BM (1995) Additive effects of obesity and hypertension to limit venous volume. Am J Physiol 268:R562–R568

    Google Scholar 

  • Tordi N, Mourot L, Matusheski B, Hughson RL (2004) Measurements of cardiac output during constant exercises: comparison of two non-invasive techniques. Int J Sports Med 25:145–149

    Article  PubMed  CAS  Google Scholar 

  • Vella CA, Zubia RY, Burns SF, Ontiveros D (2009) Cardiac response to exercise in young, normal weight and overweight men and women. Eur J Appl Physiol 105:411–419

    Article  PubMed  Google Scholar 

  • Welsman J, Bywater K, Farr C, Welford D, Armstrong N (2005) Reliability of peak VO2 and maximal cardiac output assessed using thoracic bioimpedance in children. Eur J Appl Physiol 94:228–234

    Article  PubMed  Google Scholar 

  • World Health Organization (2006) Obesity and Overweight. World Health Organization Media Center, Fact Sheet 311

Download references

Acknowledgments

The authors would like to thank all the participants who took part in this study, Stephen Burns, Ph.D. for external review of the paper, and the University of Texas Research Institute for funding a part of the study.

Conflict of interest

The authors have no conflicts of interest to disclose.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Chantal A. Vella.

Additional information

Communicated by Susan Ward.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Vella, C.A., Ontiveros, D. & Zubia, R.Y. Cardiac function and arteriovenous oxygen difference during exercise in obese adults. Eur J Appl Physiol 111, 915–923 (2011). https://doi.org/10.1007/s00421-010-1554-z

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00421-010-1554-z

Keywords

Navigation