Relation of Regional Fat Distribution to Left Ventricular Structure and Function

被引:160
作者
Neeland, Ian J. [1 ]
Gupta, Sachin [1 ]
Ayers, Colby R. [1 ,2 ]
Turer, Aslan T. [1 ]
Rame, J. Eduardo [4 ]
Das, Sandeep R. [1 ]
Berry, Jarett D. [1 ]
Khera, Amit [1 ]
McGuire, Darren K. [1 ,2 ]
Vega, Gloria L. [3 ]
Grundy, Scott M. [3 ]
de Lemos, James A. [1 ]
Drazner, Mark H. [1 ]
机构
[1] Univ Texas SW Med Ctr Dallas, Div Cardiol, Dept Internal Med, Dallas, TX 75390 USA
[2] Univ Texas SW Med Ctr Dallas, Dept Clin Sci, Dallas, TX 75390 USA
[3] Univ Texas SW Med Ctr Dallas, Ctr Human Nutr, Dallas, TX 75390 USA
[4] Univ Penn, Cardiovasc Res Inst, Philadelphia, PA 19104 USA
基金
美国国家卫生研究院;
关键词
body fat distribution; concentric remodeling; hypertrophy; left ventricular; intra-abdominal fat; obesity; CARDIOVASCULAR RISK-FACTORS; BODY-FAT; INSULIN-RESISTANCE; HEART-FAILURE; OBESITY; MASS; ASSOCIATION; IMPACT; DETERMINANT; POPULATION;
D O I
10.1161/CIRCIMAGING.113.000532
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background The relation of body fat distribution to left ventricular (LV) structure and function is poorly defined. Methods and Results A total of 2710 participants without heart failure or LV dysfunction in the Dallas Heart Study underwent dual energy x-ray absorptiometry and MRI assessment of fat distribution, LV morphology, and hemodynamics. Cross-sectional associations of fat distribution with LV structure and function were examined after adjustment for age, sex, race, comorbidities, and lean mass. Mean age was 44 years with 55% women; 48% blacks; and 44% obese. After multivariable adjustment, visceral adipose tissue was associated with concentric remodeling characterized by lower LV end-diastolic volume (=-0.21), higher concentricity (=0.20), and wall thickness (=0.09; P<0.0001 for all). In contrast, lower body subcutaneous fat was associated with higher LV end-diastolic volume (=0.48), reduced concentricity (=-0.50), and wall thickness (=-0.28, P<0.0001 for all). Visceral adipose tissue was also associated with lower cardiac output (=-0.10, P<0.05) and higher systemic vascular resistance (=0.08, P<0.05), whereas lower body subcutaneous fat associated with higher cardiac output (=0.20, P<0.0001) and lower systemic vascular resistance (=-0.18, P<0.0001). Abdominal subcutaneous fat showed weaker associations with concentric remodeling and was not associated with hemodynamics. Among the subset of obese participants, visceral adipose tissue, but not abdominal subcutaneous fat, was significantly associated with concentric remodeling. Conclusions Visceral adipose tissue, a marker of central adiposity, was independently associated with concentric LV remodeling and adverse hemodynamics. In contrast, lower body subcutaneous fat was associated with eccentric remodeling. The impact of body fat distribution on heart failure risk requires prospective study.
引用
收藏
页码:800 / 807
页数:8
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