{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T23:56:29Z","timestamp":1792799789140,"version":"4.5.0"},"reference-count":24,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2021,8,28]],"date-time":"2021-08-28T00:00:00Z","timestamp":1630108800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"British Heart Foundation Clinical Intermediate Research Fellowship","award":["FS\/16\/70\/32157"],"award-info":[{"award-number":["FS\/16\/70\/32157"]}],"id":[{"id":"https:\/\/ror.org\/02wdwnk04","id-type":"ROR","asserted-by":"crossref"}]},{"name":"British Heart Foundation Oxford Centre of Research Excellence","id":[{"id":"https:\/\/ror.org\/02wdwnk04","id-type":"ROR","asserted-by":"crossref"}]},{"name":"National Institute for Health Research Oxford Biomedical Research Centre","id":[{"id":"https:\/\/ror.org\/0187kwz08","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,9,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>We aimed to determine the effect of increasing body weight upon right ventricular (RV) volumes, energetics, systolic function, and stress responses using cardiovascular magnetic resonance (CMR).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>We first determined the effects of World Health Organization class III obesity [body mass index (BMI) &amp;gt; 40 kg\/m2, n = 54] vs. healthy weight (BMI &amp;lt; 25 kg\/m2, n = 49) upon RV volumes, energetics and systolic function using CMR. In less severe obesity (BMI 35 \u00b1 5 kg\/m2, n = 18) and healthy weight controls (BMI 21 \u00b1 1 kg\/m2, n = 9), we next performed CMR before and during dobutamine to evaluate RV stress response. A subgroup undergoing bariatric surgery (n = 37) were rescanned at median 1 year to determine the effects of weight loss. When compared with healthy weight, class III obesity was associated with adverse RV remodelling (17% RV end-diastolic volume increase, P &amp;lt; 0.0001), impaired cardiac energetics (19% phosphocreatine to adenosine triphosphate ratio reduction, P &amp;lt; 0.001), and reduction in RV ejection fraction (by 3%, P = 0.01), which was related to impaired energetics (R = 0.3, P = 0.04). Participants with less severe obesity had impaired RV diastolic filling at rest and blunted RV systolic and diastolic responses to dobutamine compared with healthy weight. Surgical weight loss (34 \u00b1 15 kg weight loss) was associated with improvement in RV end-diastolic volume (by 8%, P = 0.006) and systolic function (by 2%, P = 0.03).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Increasing body weight is associated with significant alterations in RV volumes, energetic, systolic function, and stress responses. Adverse RV modelling is mitigated with weight loss. Randomized trials are needed to determine whether intentional weight loss improves symptoms and outcomes in patients with obesity and heart failure.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjci\/jeab175","type":"journal-article","created":{"date-parts":[[2021,8,16]],"date-time":"2021-08-16T23:14:09Z","timestamp":1629155649000},"page":"1383-1390","source":"Crossref","is-referenced-by-count":34,"title":["Adverse right ventricular remodelling, function, and stress responses in obesity: insights from cardiovascular magnetic resonance"],"prefix":"10.1093","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3714-6711","authenticated-orcid":false,"given":"Andrew J M","family":"Lewis","sequence":"first","affiliation":[{"name":"University of Oxford Centre for Clinical Magnetic Resonance Research, Radcliffe Department of Medicine, University of Oxford, Headley Way , Oxford OX3 9DU , 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