Cardiovascular Imaging in Obesity

Review

Cardiovascular Imaging in Obesity

Sophie I. Mavrogeni ^1,2, Flora Bacopoulou ² , George Markousis-Mavrogenis ¹ , George Chrousos ^2,3,4 and Evangelia Charmandari ^3,4,*

1 Onassis Cardiac Surgery Center, 17674 Athens, Greece; sophie.mavrogeni@gmail.com (S.I.M.); georgemm32@gmail.com (G.M.-M.)

2 University Research Institute of Maternal and Child Health and Precision Medicine, and UNESCO Chair on Adolescent Health Care, National and Kapodistrian University of Athens Medical School, ‘Aghia Sophia’ Children’s Hospital, 11527 Athens, Greece; bacopouf@hotmail.com (F.B.); chrousos@gmail.com (G.C.)

3 Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, ‘Aghia Sophia’ Children’s Hospital, 11527 Athens, Greece

4 Division of Endocrinology and Metabolism, Center for Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, 11527 Athens, Greece

* Correspondence: evangelia.charmandari@googlemail.com; Tel./Fax: +30-213-2013384

Received: 5 February 2021 / Revised: 22 February 2021 / Accepted: 23 February 2021 / Published: 26 February 2021

Abstract: Obesity represents one of the most challenging public health problems of our century. It accounts for approximately 5% of deaths worldwide, mostly owing to cardiovascular disease and its associated complications. Cardiovascular noninvasive imaging may provide early accurate information about hypertrophy and ischemia/fibrosis in obese subjects. Echocardiography and nuclear cardiology have serious limitations in obese subjects owing to poor acoustic window and attenuation artifacts, respectively. Coronary computed tomography angiography can provide information about obstructive coronary disease; however, the use of radiation is a serious disadvantage. Finally, cardiac magnetic resonance (CMR) holds the promise of an “all in one” examination by combining evaluation of function, wall motion/thickness, stress rest/perfusion, replacement and diffuse fibrosis without radiation. Future studies are required to document the cost/benefit ratio of the CMR in the evaluation of cardiovascular risk in overweight/obese children and adolescents.

Keywords: cardiovascular magnetic resonance; obesity; echocardiography; nuclear cardiology; coronary artery computed tomography