The Impact of Obesity on the Left Ventricle The Multi-Ethnic Study of Atherosclerosis (MESA)

JACC-CARDIOVASCULAR IMAGING

卷:3

Article

Turkbey, Evrim B.¹  McClelland, Robyn L.²  Kronmal, Richard A.²  Burke, Gregory L.³  Bild, Diane E.⁴  Tracy, Russell P.^6,7  Arai, Andrew E.⁵  Lima, Joao A. C.⁸  Bluemke, David A.¹ 

[1] NIH, Ctr Clin, Bethesda, MD 20892 USA

[2] Univ Washington, Dept Biostat, Seattle, WA 98195 USA

[3] Wake Forest Univ Hlth Sci, Div Publ Hlth Sci, Winston Salem, NC USA

[4] NHLBI, Div Cardiovasc Sci, NIH, Bethesda, MD 20892 USA

[5] NHLBI, Cardiac Energet Lab, NIH, Bethesda, MD 20892 USA

[6] Univ Vermont, Dept Pathol, Colchester, VT USA

[7] Univ Vermont, Dept Biochem, Colchester, VT USA

[8] Johns Hopkins Univ, Dept Med, Div Cardiol, Baltimore, MD USA

关键词: cardiac magnetic resonance;    cardiac morphology;    epidemiology;    left ventricular function;    obesity;   

DOI  :  10.1016/j.jcmg.2009.10.012

来源: Elsevier

【 摘 要 】

OBJECTIVES The purpose of this study was to evaluate the relationship of left ventricular (LV) remodeling assessed by cardiac magnetic resonance to various measures of obesity in a large population-based study. BACKGROUND Obesity is a well-known risk factor for cardiovascular disease, yet its relationship with LV size and function is poorly understood. METHODS A total of 5,098 participants (age 45 to 84 years; 48% men) in the Multi-Ethnic Study of Atherosclerosis who were free of clinically apparent cardiovascular disease underwent cardiac magnetic resonance to assess LV size and function as well as measures of obesity, including body mass index, waist-to-hip ratio and waist circumference, and cardiovascular risk factors. Fat mass (FM) was estimated based on height-weight models derived from bioelectrical impedance studies. The associations of obesity measures with LV size and function were evaluated using linear spline regression models for body mass index and multivariable regression models for other measures of obesity; they were displayed graphically using generalized additive models. RESULTS LV mass and end-diastolic volume were positively associated with measures of obesity in both sexes after adjustment for risk factors (e. g., 5.7-g and 6.9-g increase in LV mass per 10-kg increase in FM in women and men, respectively [p < 0.001]). LV mass-to-volume ratio was positively associated with increased body mass index, waist-to-hip ratio, waist circumference, and estimated FM (e. g., 0.02-g/ml and 0.06-g/ml increase in mass-to-volume ratio per 10-kg increase in FM in women and men, respectively [p < 0.001]). The increased mass-to-volume ratio was due to a greater increase in LV mass relative to LV end-diastolic volume. All associations were stronger for men than for women. Ejection fraction showed no significant association with measures of obesity. CONCLUSIONS Obesity was associated with concentric LV remodeling without change in ejection fraction in a large, multiethnic cohort study. (J Am Coll Cardiol Img 2010; 3: 266-74) (C) 2010 by the American College of Cardiology Foundation

【 授权许可】

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