Transthoracic echocardiography
Interventricular septal thickness, obesity, Diastolic dysfunction
OBESITY, DIASTOLIC DYSFUNCTION, DECUBITUS
Two-dimensional grayscale harmonic images were obtained in the left lateral decubitus position using a commercially available ultrasound system (EPIQ 7, Philips, the Netherlands), equipped with a broadband (1-5 MHz) X5-1 transducer. Diastolic dysfunction and reduced ejection fraction (≤ 54% in females, and ≤ 52% in males) were defined according to the current guidelines [Interventricular septal thickness (IVSd), posterior wall thickness (PWd), and LV dimension (LVEDD) were all measured at end-diastole. The LV mass (LVM) was calculated according to the Deveraux formula using these measurements: LVM (g) = 0.80 × {1.04[(IVSd + LVEDD + PWd)To optimize speckle tracking echocardiography, apical images were obtained at a frame rate of 60 to 80 frames/s. Three consecutive cardiac cycles were acquired from all apical views (4-chamber, 2-chamber, and 3-chamber). Subsequently, these cycles were transferred to a QLAB workstation (version 10.2, Philips, the Netherlands) for off-line speckle tracking analysis. Peak regional longitudinal strain was measured in 17 myocardial regions and a weighted mean was used to derive global longitudinal strain (GLS) (Fig. 
Measurement of global longitudinal strain (GLS) by speckle tracking analysis in an obesity patient (45 year old female, BMI 38.4 kg/m