Regional adiposity, cardiorespiratory fitness, and left ventricular strain: an analysis from the Dallas Heart Study

Journal of Cardiovascular Magnetic Resonance

Colby Ayers¹  Kershaw V. Patel²  Neela Thangada³  Ian J. Neeland⁴  Ambarish Pandey⁵  Alvin Chandra⁵  Jarret D. Berry⁵  Nitin Kondamudi⁵ 

[1] Department of Clinical Sciences, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, 75390-9047, Dallas, TX, USA;Division of Cardiology, Department of Internal Medicine, Houston Methodist Hospital, 6550 Fannin St., 77030, Houston, TX, USA;Division of Cardiology, Department of Internal Medicine, Northwestern University, Feinberg School of Medicine, 60611, Chicago, IL, USA;Division of Cardiology, Department of Internal Medicine, University Hospitals Harrington Heart and Vascular Institute and Case Western Reserve University School of Medicine, 2103 Cornell Road, 44106, Cleveland, OH, USA;Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, 75390-9047, Dallas, TX, USA;

关键词: Visceral fat;    Lower-body fat;    Subcutaneous fat;    Left ventricular peak circumferential strain;    Heart failure;   

DOI  :  10.1186/s12968-021-00757-w

来源: Springer

【 摘 要 】

BackgroundLow cardiorespiratory fitness (CRF), high body mass index, and excess visceral adiposity are each associated with impairment in left ventricular (LV) peak circumferential strain (Ecc), an intermediate phenotype that precedes the development of clinical heart failure (HF). However, the association of regional fat distribution and CRF with Ecc independent of each other and other potential confounders is not known.MethodsParticipants from the Dallas Heart Study Phase 2 who underwent dual energy X-ray absorptiometry assessment of regional fat distribution, CRF assessment by submaximal treadmill test, and Ecc quantification by tissue-tagged cardiovascular magnetic resonance were included in the analysis. The cross-sectional associations of measures of regional adiposity, namely visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and lower-body fat (LBF) with Ecc after adjustment for CRF and other potential confounders (independent variables) were assessed using multivariable linear regression analysis.ResultsThe study included 1089 participants (55% female, 39% black). In the unadjusted analysis, higher VAT was associated with greater impairment in Ecc. After adjustment for baseline risk factors, CRF, parameters of LV structure and function, and other fat depots such as SAT and LBF, higher VAT remained associated with greater impairment in Ecc (β: 0.19, P = 0.002). SAT and LBF were not significantly associated with Ecc, however, CRF remained associated with Ecc in the fully adjusted model including all fat depots (β: − 0.15, P < 0.001).ConclusionsVAT and CRF are each independently associated with impairment in Ecc, suggesting that higher VAT burden and low CRF mediate pathological cardiac remodeling through distinct mechanisms.

【 授权许可】

CC BY