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Eur J Prev Cardiol. 2015 Nov;22(11):1408-18. doi: 10.1177/2047487314541731. Epub 2014 Jul 9.

Weight loss and progressive left ventricular remodelling: The Multi-Ethnic Study of Atherosclerosis (MESA).

Author information

1
Cardiology Division, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA.
2
Department of Medicine (Cardiovascular Medicine Division) and Department of Radiology (Nuclear Medicine and Cardiothoracic Imaging Divisions), University of Michigan, Ann Arbor, MI, USA.
3
Non-Invasive Cardiovascular Imaging, Brigham and Women's Hospital, Boston, MA, USA.
4
Office of Biostatistics Research, National Heart, Lung, and Blood Institute, Bethesda, MD, USA.
5
Cardiology Division, Johns Hopkins Bayview Medical Center, Baltimore, MD, USA.
6
Joslin Diabetes Center, Boston, MA, USA.
7
Radiology and Imaging Sciences, National Institutes of Health Clinical Center, National Institute of Biomedical Imaging and Bioengineering, Bethesda, MD, USA.
8
Department of Cardiology and Medicine, Johns Hopkins Medical Center, Baltimore, MD, USA.
9
Non-Invasive Cardiovascular Imaging, Brigham and Women's Hospital, Boston, MA, USA mjerosch-herold@partners.org.

Abstract

AIMS:

Impact of weight loss on cardiac structure has not been extensively investigated in large, multi-ethnic, community-based populations. We investigated the longitudinal impact of weight loss on cardiac structure by cardiac magnetic resonance (CMR).

METHODS AND RESULTS:

2351 participants in the Multi-Ethnic Study of Atherosclerosis (MESA) who underwent CMR at Exam 1 (2002) and Exam 5 (2011) were included. Primary outcomes were percentage change in LV mass (indexed to height) and LV mass-to-volume ratio (concentric LV remodelling). Multivariable linear regression was used to measure the association between outcomes and weight change. At median 9.4 years' follow-up, 639 individuals (27%) experienced >5% weight loss (median 6.9 kg) and 511 (22%) had >5% weight gain (median 6.4 kg). A >5% weight gain was associated with the greatest increase in LV mass (+5.4% median) and LV mass-to-volume ratio (+12.2% median). Adjusting for medications, hypertension/diabetes (and change in these risk factors), age, race and other risk factors, every 5% weight loss was associated with a 1.3% decrease in height-indexed LV mass and 1.3% decrease in LV mass-to-volume ratio (p<0.0001). There was no effect modification/confounding by age, race, gender or baseline BMI. Change in LV mass-to-volume ratio was roughly linear, specifically for modest degrees of weight loss (-10% to +10%). Change in LV mass was linear with weight loss, suggesting no threshold of weight loss is needed for LV mass regression.

CONCLUSIONS:

In a large multi-ethnic population, weight loss is associated with beneficial effects on cardiac structure, independent of age, race, gender, BMI and obesity-related cardiometabolic risk. There is no threshold of weight loss required to produce these effects.

KEYWORDS:

Obesity; cardiac magnetic resonance; weight loss

PMID:
25009171
PMCID:
PMC4754791
DOI:
10.1177/2047487314541731
[Indexed for MEDLINE]
Free PMC Article
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