Gender-specific differences in left ventricular remodelling in obesity: insights from cardiovascular magnetic resonance imaging.

AIMS: As obesity-related cardiovascular mortality, although elevated when compared with normal weight, is lower in females than in males at every body mass index (BMI) level, we aimed to investigate gender-specific differences in left ventricular (LV) hypertrophy in obesity, which themselves have be...

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Main Authors: Rider, O, Lewandowski, A, Nethononda, R, Petersen, SE, Francis, J, Pitcher, A, Holloway, C, Dass, S, Banerjee, R, Byrne, J, Leeson, P, Neubauer, S
Format: Journal article
Language:English
Published: 2013
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author Rider, O
Lewandowski, A
Nethononda, R
Petersen, SE
Francis, J
Pitcher, A
Holloway, C
Dass, S
Banerjee, R
Byrne, J
Leeson, P
Neubauer, S
author_facet Rider, O
Lewandowski, A
Nethononda, R
Petersen, SE
Francis, J
Pitcher, A
Holloway, C
Dass, S
Banerjee, R
Byrne, J
Leeson, P
Neubauer, S
author_sort Rider, O
collection OXFORD
description AIMS: As obesity-related cardiovascular mortality, although elevated when compared with normal weight, is lower in females than in males at every body mass index (BMI) level, we aimed to investigate gender-specific differences in left ventricular (LV) hypertrophy in obesity, which themselves have been shown to have varying prognostic value. METHOD AND RESULTS: In total, 741 subjects (female, n = 399) without identifiable cardiovascular risk factors (BMI 15.7-59.2 kg/m(2)) underwent cardiovascular magnetic resonance (1.5 T) to determine LV mass, end-diastolic volume (EDV, mL), and LV mass/volume ratio (LVM/VR). Across both sexes, there was a strong positive correlation between BMI and LV mass (male r = 0.44, female r = 0.57, both P < 0.001), with males showing a greater LV hypertrophic response (male +2.3 vs. female +1.6 g per BMI point increase, P = 0.001). Concentric hypertrophy was present in both sexes and LVM/VR positively correlated to BMI (male r = 0.45, female r = 0.29, both P < 0.001) on linear regression analysis. However, the degree of concentric hypertrophy was greater in males (male +0.13 vs. female +0.06 LVM/VR increase per BMI point increase, P = 0.001). On the other hand, females showed a greater LV cavity dilatory response (female +1.1 vs. male +0.3 mL per BMI point increase, P < 0.001). Indeed, in contrast to females, where BMI and LV-EDV were positively correlated (r = 0.38, P < 0.001), BMI did not correlate with EDV in men (r = 0.03, P = 0.62). CONCLUSION: In the absence of traditional cardiovascular risk factors, obese men show predominantly concentric hypertrophy, whereas obese women exhibit both eccentric and concentric hypertrophy. As concentric hypertrophy is more strongly related to cardiovascular mortality than eccentric hypertrophy, our observations may explain the observed gender difference in obesity-related mortality.
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spelling oxford-uuid:b700732d-74e3-4024-b841-088826e989142022-03-27T04:45:10ZGender-specific differences in left ventricular remodelling in obesity: insights from cardiovascular magnetic resonance imaging.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:b700732d-74e3-4024-b841-088826e98914EnglishSymplectic Elements at Oxford2013Rider, OLewandowski, ANethononda, RPetersen, SEFrancis, JPitcher, AHolloway, CDass, SBanerjee, RByrne, JLeeson, PNeubauer, SAIMS: As obesity-related cardiovascular mortality, although elevated when compared with normal weight, is lower in females than in males at every body mass index (BMI) level, we aimed to investigate gender-specific differences in left ventricular (LV) hypertrophy in obesity, which themselves have been shown to have varying prognostic value. METHOD AND RESULTS: In total, 741 subjects (female, n = 399) without identifiable cardiovascular risk factors (BMI 15.7-59.2 kg/m(2)) underwent cardiovascular magnetic resonance (1.5 T) to determine LV mass, end-diastolic volume (EDV, mL), and LV mass/volume ratio (LVM/VR). Across both sexes, there was a strong positive correlation between BMI and LV mass (male r = 0.44, female r = 0.57, both P < 0.001), with males showing a greater LV hypertrophic response (male +2.3 vs. female +1.6 g per BMI point increase, P = 0.001). Concentric hypertrophy was present in both sexes and LVM/VR positively correlated to BMI (male r = 0.45, female r = 0.29, both P < 0.001) on linear regression analysis. However, the degree of concentric hypertrophy was greater in males (male +0.13 vs. female +0.06 LVM/VR increase per BMI point increase, P = 0.001). On the other hand, females showed a greater LV cavity dilatory response (female +1.1 vs. male +0.3 mL per BMI point increase, P < 0.001). Indeed, in contrast to females, where BMI and LV-EDV were positively correlated (r = 0.38, P < 0.001), BMI did not correlate with EDV in men (r = 0.03, P = 0.62). CONCLUSION: In the absence of traditional cardiovascular risk factors, obese men show predominantly concentric hypertrophy, whereas obese women exhibit both eccentric and concentric hypertrophy. As concentric hypertrophy is more strongly related to cardiovascular mortality than eccentric hypertrophy, our observations may explain the observed gender difference in obesity-related mortality.
spellingShingle Rider, O
Lewandowski, A
Nethononda, R
Petersen, SE
Francis, J
Pitcher, A
Holloway, C
Dass, S
Banerjee, R
Byrne, J
Leeson, P
Neubauer, S
Gender-specific differences in left ventricular remodelling in obesity: insights from cardiovascular magnetic resonance imaging.
title Gender-specific differences in left ventricular remodelling in obesity: insights from cardiovascular magnetic resonance imaging.
title_full Gender-specific differences in left ventricular remodelling in obesity: insights from cardiovascular magnetic resonance imaging.
title_fullStr Gender-specific differences in left ventricular remodelling in obesity: insights from cardiovascular magnetic resonance imaging.
title_full_unstemmed Gender-specific differences in left ventricular remodelling in obesity: insights from cardiovascular magnetic resonance imaging.
title_short Gender-specific differences in left ventricular remodelling in obesity: insights from cardiovascular magnetic resonance imaging.
title_sort gender specific differences in left ventricular remodelling in obesity insights from cardiovascular magnetic resonance imaging
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