Characteristics and Impact of Obesity on the Outpatient Echocardiography Laboratory

The impact of the growing obesity epidemic on the outpatient echocardiography laboratory and the characteristics of these patients were retrospectively investigated. Over a 6-month period, 916 patients were referred for study, 49.7% of whom were obese (body mass index >29.9 kg/m2), whereas only 22.3% were normal weight (body mass index 18.5 to 25 kg/m2). The obese patients were more likely to be female, black, older, and referred because of dyspnea or suspected heart failure (58.1% vs 36.8%, p <0.001). Despite a poorer quality of echocardiographic studies requiring more use of intravenous left heart contrast, the left ventricular ejection fraction was estimated in a similar proportion of these patients (93.9% vs 96.6%, p = 0.016). However, pulmonary artery systolic pressure measurement was less sucessfully obtained (66.6% vs 80.6%, p = 0.002). Thus, the demographics and referral diagnoses of obese patients differ significantly from normal weight patients, and body habitus presents unique imaging challenges that were only partially met while consuming greater resources.