Cardiac phenotype in class III obesity assessed using CMR. (A) Participants of healthy weight and with class III obesity underwent 1.5T and 3T CMR and a subgroup underwent 31P MRS. (B) Assessment of cardiac volumes and systolic function using CMR (red—LV endocardium, green—LV epicardium, orange—left atrium, and yellow—right ventricular endocardium) including feature tracking strain analysis and representative 31P spectrum. (C) Class III obesity was associated with RV dilatation and systolic dysfunction which was associated with impairment of cardiac energetics. (D) Class III obesity was associated with LV remodelling and impairment of systolic but not diastolic function. Unless otherwise stated data are presented as mean ± standard deviation, *P < 0.05, **P < 0.01, ***P < 0.001. Hollow circles denote participants with healthy weight, black circles those with class III obesity.
