Dynamic Relation of Changes in Weight and Indices of Fat Distribution With Cardiac Structure and Function: The Dallas Heart Study
BackgroundObesity may increase heart failure risk through cardiac remodeling. Cross‐sectional associations between adiposity and cardiac structure and function have been elucidated, but the impact of longitudinal changes in adiposity on cardiac remodeling is less well understood. Methods and Results...
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Format: | Article |
Language: | English |
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Wiley
2017-07-01
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Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
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Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.117.005897 |
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author | Bryan Wilner Sonia Garg Colby R. Ayers Christopher D. Maroules Roderick McColl Susan A. Matulevicius James A. de Lemos Mark H. Drazner Ronald Peshock Ian J. Neeland |
author_facet | Bryan Wilner Sonia Garg Colby R. Ayers Christopher D. Maroules Roderick McColl Susan A. Matulevicius James A. de Lemos Mark H. Drazner Ronald Peshock Ian J. Neeland |
author_sort | Bryan Wilner |
collection | DOAJ |
description | BackgroundObesity may increase heart failure risk through cardiac remodeling. Cross‐sectional associations between adiposity and cardiac structure and function have been elucidated, but the impact of longitudinal changes in adiposity on cardiac remodeling is less well understood. Methods and ResultsParticipants in the Dallas Heart Study without cardiovascular disease or left ventricular dysfunction underwent assessment of body weight, anthropometrics, and cardiac magnetic resonance imaging at baseline and 7 years later. Associations between changes in indices of generalized and central adiposity with changes in left ventricular mass, volume, mass/volume ratio (concentricity), wall thickness, and ejection fraction were assessed using multivariable linear regression. The study cohort (n=1262) mean age was 44 years with 57% women, 44% black, and 36% obese participants. At follow‐up, 41% had ≥5% weight gain, and 15% had ≥5% weight loss. Greater weight gain was associated with younger age, lower risk factor burden, and lower body mass index at baseline. In multivariable models adjusting for age, sex, race, comorbid conditions at baseline and follow‐up, baseline adiposity, and cardiac measurement, increasing weight was associated with increases in left ventricular mass (β=0.10, P<0.0001), wall thickness (β=0.10, P<0.0001), and concentricity (β=0.06, P=0.002), with modest effects on end‐diastolic volume (β=0.04, P=0.044) and ejection fraction (β=0.05, P=0.046). Similar results were seen with other adiposity indices. ConclusionsConcentric left ventricular remodeling is the predominant phenotype linked to increasing adiposity in middle age. Our findings support the importance of weight management to prevent secular changes in adiposity, concentric remodeling, and eventual heart failure over time. |
first_indexed | 2024-04-13T15:36:15Z |
format | Article |
id | doaj.art-181993c8458d4e4baedb2825627d4d27 |
institution | Directory Open Access Journal |
issn | 2047-9980 |
language | English |
last_indexed | 2024-04-13T15:36:15Z |
publishDate | 2017-07-01 |
publisher | Wiley |
record_format | Article |
series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
spelling | doaj.art-181993c8458d4e4baedb2825627d4d272022-12-22T02:41:16ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802017-07-016710.1161/JAHA.117.005897Dynamic Relation of Changes in Weight and Indices of Fat Distribution With Cardiac Structure and Function: The Dallas Heart StudyBryan Wilner0Sonia Garg1Colby R. Ayers2Christopher D. Maroules3Roderick McColl4Susan A. Matulevicius5James A. de Lemos6Mark H. Drazner7Ronald Peshock8Ian J. Neeland9Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TXDivision of Cardiology, University of Texas Southwestern Medical Center, Dallas, TXDepartment of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, TXDepartment of Radiology, University of Texas Southwestern Medical Center, Dallas, TXDepartment of Radiology, University of Texas Southwestern Medical Center, Dallas, TXDivision of Cardiology, University of Texas Southwestern Medical Center, Dallas, TXDivision of Cardiology, University of Texas Southwestern Medical Center, Dallas, TXDivision of Cardiology, University of Texas Southwestern Medical Center, Dallas, TXDepartment of Radiology, University of Texas Southwestern Medical Center, Dallas, TXDivision of Cardiology, University of Texas Southwestern Medical Center, Dallas, TXBackgroundObesity may increase heart failure risk through cardiac remodeling. Cross‐sectional associations between adiposity and cardiac structure and function have been elucidated, but the impact of longitudinal changes in adiposity on cardiac remodeling is less well understood. Methods and ResultsParticipants in the Dallas Heart Study without cardiovascular disease or left ventricular dysfunction underwent assessment of body weight, anthropometrics, and cardiac magnetic resonance imaging at baseline and 7 years later. Associations between changes in indices of generalized and central adiposity with changes in left ventricular mass, volume, mass/volume ratio (concentricity), wall thickness, and ejection fraction were assessed using multivariable linear regression. The study cohort (n=1262) mean age was 44 years with 57% women, 44% black, and 36% obese participants. At follow‐up, 41% had ≥5% weight gain, and 15% had ≥5% weight loss. Greater weight gain was associated with younger age, lower risk factor burden, and lower body mass index at baseline. In multivariable models adjusting for age, sex, race, comorbid conditions at baseline and follow‐up, baseline adiposity, and cardiac measurement, increasing weight was associated with increases in left ventricular mass (β=0.10, P<0.0001), wall thickness (β=0.10, P<0.0001), and concentricity (β=0.06, P=0.002), with modest effects on end‐diastolic volume (β=0.04, P=0.044) and ejection fraction (β=0.05, P=0.046). Similar results were seen with other adiposity indices. ConclusionsConcentric left ventricular remodeling is the predominant phenotype linked to increasing adiposity in middle age. Our findings support the importance of weight management to prevent secular changes in adiposity, concentric remodeling, and eventual heart failure over time.https://www.ahajournals.org/doi/10.1161/JAHA.117.005897adipose tissuebody mass indexcardiac remodelingdual x‐ray absorptiometrymagnetic resonance imagingobesity |
spellingShingle | Bryan Wilner Sonia Garg Colby R. Ayers Christopher D. Maroules Roderick McColl Susan A. Matulevicius James A. de Lemos Mark H. Drazner Ronald Peshock Ian J. Neeland Dynamic Relation of Changes in Weight and Indices of Fat Distribution With Cardiac Structure and Function: The Dallas Heart Study Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease adipose tissue body mass index cardiac remodeling dual x‐ray absorptiometry magnetic resonance imaging obesity |
title | Dynamic Relation of Changes in Weight and Indices of Fat Distribution With Cardiac Structure and Function: The Dallas Heart Study |
title_full | Dynamic Relation of Changes in Weight and Indices of Fat Distribution With Cardiac Structure and Function: The Dallas Heart Study |
title_fullStr | Dynamic Relation of Changes in Weight and Indices of Fat Distribution With Cardiac Structure and Function: The Dallas Heart Study |
title_full_unstemmed | Dynamic Relation of Changes in Weight and Indices of Fat Distribution With Cardiac Structure and Function: The Dallas Heart Study |
title_short | Dynamic Relation of Changes in Weight and Indices of Fat Distribution With Cardiac Structure and Function: The Dallas Heart Study |
title_sort | dynamic relation of changes in weight and indices of fat distribution with cardiac structure and function the dallas heart study |
topic | adipose tissue body mass index cardiac remodeling dual x‐ray absorptiometry magnetic resonance imaging obesity |
url | https://www.ahajournals.org/doi/10.1161/JAHA.117.005897 |
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