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Nutr Metab Cardiovasc Dis. 2015 Jul;25(7):667-76. doi: 10.1016/j.numecd.2015.03.016. Epub 2015 Apr 16.

Visceral adiposity and left ventricular remodeling: The Multi-Ethnic Study of Atherosclerosis.

Author information

1
Department of Medicine (Cardiology Division), Warren Alpert Medical School of Brown University, United States.
2
Department of Internal Medicine/Cardiology, Wake Forest University Health Sciences, Winston-Salem, NC, United States.
3
National Institutes of Health Clinical Center, National Institute of Biomedical Imaging and Bioengineering, Bethesda, MD, United States.
4
Department of Radiology, Brigham and Women's Hospital, Boston, MA, United States.
5
Noninvasive Cardiovascular Imaging Program, Department of Medicine (Cardiovascular Division) and Department of Radiology, Brigham and Women's Hospital, Boston, MA, United States.
6
William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, London, UK.
7
Department of Cardiovascular Medicine, University of Oxford, Oxford, UK.
8
Division of Cardiology, Heart and Vascular Institute, Johns Hopkins School of Medicine, Baltimore, MD, Unites Sates.
9
Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, CA, United States.
10
Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, Unites states; Division of Nuclear Medicine, Department of Radiology, University of Michigan, Ann Arbor, MI, United States. Electronic address: vlmurthy@med.umich.edu.
11
Department of Medicine, Cardiovascular Division, Beth Israel Deaconess Medical Center, Boston, MA, United States. Electronic address: rshah1@bidmc.harvard.edu.

Abstract

BACKGROUND AND AIMS:

Visceral fat (VF) is a source of pro-inflammatory adipokines implicated in cardiac remodeling. We sought to determine the impact of visceral fat and subcutaneous fat (SQ) depots on left ventricular (LV) structure, function, and geometry in the Multi-Ethnic Study of Atherosclerosis (MESA).

METHODS AND RESULTS:

We performed a post-hoc analysis on 1151 participants from MESA with cardiac magnetic resonance quantification of LV mass and LV mass-to-volume ratio (LVMV, an index of concentricity) and computed tomographic-derived SQ and VF area. Multivariable regression models to estimate association between height-indexed SQ and VF area (per cm(2)/m) with height-indexed LV mass (per height(2.7)) and LVMV were constructed, adjusted for clinical, biochemical, and demographic covariates. We found that both VF and SQ area were associated with height-indexed LV mass (ρ = 0.36 and 0.12, P < 0.0001, respectively), while only VF area was associated with LVMV (ρ = 0.28, P < 0.0001). Individuals with above-median VF had lower LV ejection fraction, greater indexed LV volumes and mass, and higher LVMV (all P < 0.001). In multivariable models adjusted for weight, VF (but not SQ) area was associated with LV concentricity and LV mass index, across both sexes.

CONCLUSION:

Visceral adiposity is independently associated with LV concentricity, a precursor to heart failure. Further study into the role of VF in LV remodeling as a potential therapeutic target is warranted.

KEYWORDS:

Cardiac magnetic resonance imaging; Obesity; Remodeling; Visceral adiposity

PMID:
26033394
PMCID:
PMC4468023
DOI:
10.1016/j.numecd.2015.03.016
[Indexed for MEDLINE]
Free PMC Article

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