الفهرس 
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Abstract
Forty five case with different degrees of obsity were enrolled in this prospective study, (mean age was 33.80 ± 8.34years, 11 male and 34female)and twenty control subjects, all of them underwent echocardiography at Mansoura Specialized Medical Hospital.Proper history taking, physical examination were done. Then 12-lead resting surface electrocardiogram. Each subject’s height was determined while subject standing without shoes and weight (kg) was determined by using a mechanical scale.The body mass index (BMI) was calculated as weight in kilograms divided by the square of height in meters& Obesity was defined as a BMI ≥ 30 kg/m2 (World Health Organization, 1997) (86).The waist circumference was measured at the part of the trunk located midway between the lower costal margin, and the iliac crest at the end of expiration while the person is standing with feet about 25–30 cm apart; An increased waist circumference was defined as being greater than 88 cm in women and 102 cm in men(Canadian guidline)..Standard transthoracic echocardiogram (TTE).Left ventricular longitudinal strain and strain rate imaging. The study showed that Aortic diameter and left atrial diameter were significantly higher in patients than control group. Also Interventricular septum thickness and left ventricular posterior wall thickness were significantly higher in patients than control group [P<0.001]. On the contrary, there was no significant difference between patients and control regarding left ventricular diameter in diastole, left ventricular diameter in systole, ejection fraction. shows that global longitudinal strain of the inferior wall was significantly lower in patients group than control group [P <0.001], and this significance exists in all classes of obesity global longitudinal strain of the anterior wall was significantly lower in obese patients [P<0.05], and this significance exists in all classes of obesity global longitudinal strain of the Anteroseptal wall was significantly lower in obese patients [P<0.05], but comparing control group with each class of obesity the significance exists only when comparing control group with class IIIthere was significant decrease in glopal longitudinal strain in patient group in comparison with control group.