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The impact of obesity on the left ventricle: the Multi-Ethnic Study of Atherosclerosis (MESA).
JACC Cardiovasc Imaging 2010; 3(3):266-74JC

Abstract

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.

Authors+Show Affiliations

Radiology and Imaging Sciences, National Institutes of Health/Clinical Center, Bethesda, Maryland 20892, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

20223423

Citation

Turkbey, Evrim B., et al. "The Impact of Obesity On the Left Ventricle: the Multi-Ethnic Study of Atherosclerosis (MESA)." JACC. Cardiovascular Imaging, vol. 3, no. 3, 2010, pp. 266-74.
Turkbey EB, McClelland RL, Kronmal RA, et al. The impact of obesity on the left ventricle: the Multi-Ethnic Study of Atherosclerosis (MESA). JACC Cardiovasc Imaging. 2010;3(3):266-74.
Turkbey, E. B., McClelland, R. L., Kronmal, R. A., Burke, G. L., Bild, D. E., Tracy, R. P., ... Bluemke, D. A. (2010). The impact of obesity on the left ventricle: the Multi-Ethnic Study of Atherosclerosis (MESA). JACC. Cardiovascular Imaging, 3(3), pp. 266-74. doi:10.1016/j.jcmg.2009.10.012.
Turkbey EB, et al. The Impact of Obesity On the Left Ventricle: the Multi-Ethnic Study of Atherosclerosis (MESA). JACC Cardiovasc Imaging. 2010;3(3):266-74. PubMed PMID: 20223423.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The impact of obesity on the left ventricle: the Multi-Ethnic Study of Atherosclerosis (MESA). AU - Turkbey,Evrim B, AU - McClelland,Robyn L, AU - Kronmal,Richard A, AU - Burke,Gregory L, AU - Bild,Diane E, AU - Tracy,Russell P, AU - Arai,Andrew E, AU - Lima,João A C, AU - Bluemke,David A, PY - 2009/06/30/received PY - 2009/09/29/revised PY - 2009/10/06/accepted PY - 2010/3/13/entrez PY - 2010/3/13/pubmed PY - 2010/6/11/medline SP - 266 EP - 74 JF - JACC. Cardiovascular imaging JO - JACC Cardiovasc Imaging VL - 3 IS - 3 N2 - 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. SN - 1876-7591 UR - https://www.unboundmedicine.com/medline/citation/20223423/The_impact_of_obesity_on_the_left_ventricle:_the_Multi_Ethnic_Study_of_Atherosclerosis__MESA__ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1936-878X(09)00789-X DB - PRIME DP - Unbound Medicine ER -