A novel diastolic dysfunction score: A proposed diagnostic predictor for left ventricular dysfunction in obese population

Telly Kamelia; Cleopas M. Rumende; Lukman H. Makmun; Ina S. Timan; Samsuridjal Djauzi; Joedo Prihartono; Fauziah Fardizza; Nur A. Tabri

doi:10.52225/narra.v5i1.1564

Authors

Telly Kamelia Division of Respirology and Critical Care, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia; Division of Respirology and Critical Care, Department of Internal Medicine, Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia https://orcid.org/0000-0003-3838-8357
Cleopas M. Rumende Division of Respirology and Critical Care, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia https://orcid.org/0000-0002-7305-7337
Lukman H. Makmun Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia https://orcid.org/0000-0002-1134-375X
Ina S. Timan Department of Clinical Pathology, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia https://orcid.org/0000-0003-3730-6727
Samsuridjal Djauzi Division of Allergy and Immunology, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia https://orcid.org/0000-0002-1419-8383
Joedo Prihartono Department of Public Health, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia https://orcid.org/0009-0002-6179-9795
Fauziah Fardizza Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia https://orcid.org/0000-0001-9601-4631
Nur A. Tabri Division of Respirology and Critical Care, Department of Internal Medicine, Faculty of Medicine, Universitas Hasanuddin, Makassar, Indonesia https://orcid.org/0000-0002-0249-5671

DOI:

https://doi.org/10.52225/narra.v5i1.1564

Keywords:

Global longitudinal strain, HbA1C, obesity, oxygen desaturation index, pulmonary artery wedge pressure

Abstract

Obesity-related diastolic dysfunction is an emerging contributor to heart failure and cardiovascular mortality. However, effective and accessible diagnostic tools are still limited. Current methods for assessing diastolic dysfunction are often invasive or technologically demanding, making them impractical for routine clinical use and community settings. The aim of this study was to develop a novel, non-invasive scoring system designed to predict diastolic dysfunction in obese adults, addressing this diagnostic gap. This community-based, prospective cross-sectional study was conducted in Jakarta, Indonesia, from March to November 2021, and included 82 participants aged 18 to 60 years, all with a body mass index (BMI) ≥25 kg/m². Patients with acute or critical illnesses, valvular heart diseases, or acute confusional states were excluded. Each participant underwent blood tests, polysomnography, and echocardiography. Of the study population, 80.5% were diagnosed with obstructive sleep apnea (OSA), and 12.2% exhibited diastolic dysfunction, all within the OSA group. The novel scoring system integrates four predictors: oxygen desaturation index (ODI) ≥39 (score 1; prevalence ratio: 4.31 (95% confidence interval (CI): 1.58–11.75)), HbA1C ≥5.95% (score 2; prevalence ratio: 6.32 (95%CI: 2.84–14.06)), pulmonary artery wedge pressure (PAWP) ≥10 mmHg (score 1; prevalence ratio: 5.95 (95%CI: 2.30–15.39)), and global longitudinal strain (GLS) ≥-16.95% (score 1; prevalence ratio: 4.32 (95%CI: 1.87–9.99)). A score of ≥2 predicted diastolic dysfunction with 90% sensitivity, with positive predictive value and negative predictive value of 40.91% and 98.33%, respectively. In conclusion, the diastolic dysfunction score is a simple and practical tool for the early detection of diastolic dysfunction in obese individuals without cardiovascular symptoms.