Association of Weight and Body Composition on Cardiac Structure and Function in the ARIC Study (Atherosclerosis Risk in Communities).
Association of Weight and Body Composition on Cardiac Structure and Function in the ARIC Study (Atherosclerosis Risk in Communities).
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DOI：
10.1161/circheartfailure.115.002978
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发表时间：
2016-08
期刊：
影响因子：
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通讯作者：
Solomon SD
中科院分区：
文献类型：
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作者：
Bello NA;Cheng S;Claggett B;Shah AM;Ndumele CE;Roca GQ;Santos AB;Gupta D;Vardeny O;Aguilar D;Folsom AR;Butler KR;Kitzman DW;Coresh J;Solomon SD
肥胖会增加心血管风险。然而，各种身体成分测量值与心脏结构和功能异常的关联程度（与通常影响肥胖个体的合并症无关）尚不清楚。本研究旨在探讨体重指数 (BMI)、腰围 (WC) 和体脂百分比 (BF) 与传统和先进的心脏结构和功能测量之间的关系。我们研究了社区动脉粥样硬化风险研究的 4343 名参与者，他们年龄在 69-82 岁，无冠心病和心力衰竭，并接受了全面的超声心动图检查。无论男性还是女性，BMI、WC 和 BF 的增加均与左心室 (LV) 质量和左心房体积增大相关（P<0.001）。在女性中，所有三项指标均与左心室几何形状异常相关，而增加的 WC 和 BF 与较差的整体纵向应变（左心室收缩功能的指标）相关。无论性别，BMI 的增加均与右心室 (RV) 舒张末期面积增大和 RV 面积分数变化较差相关 (P≤0.001)。我们观察到腰围和身体脂肪百分比之间存在类似的关联。在一个大型的、无临床明显冠心病或心力衰竭的混血老年人队列中，肥胖与男性和女性心脏结构的亚临床异常有关，并且与女性的不良左心室重塑和左心室收缩功能受损有关。这些数据强调了肥胖与心脏结构和功能的亚临床异常之间的关联，特别是在女性中。
Obesity increases cardiovascular risk. However, the extent to which various measures of body composition are associated with abnormalities in cardiac structure and function, independent of comorbidities commonly affecting obese individuals, is not clear. This study sought to examine the relationship of body mass index (BMI), waist circumference (WC), and percent body fat (BF) with conventional and advanced measures of cardiac structure and function. We studied 4343 participants of the Atherosclerosis Risk in Communities Study who were aged 69-82 years, free of coronary heart disease and heart failure, and underwent comprehensive echocardiography. Increasing BMI, WC, and BF were associated with greater left ventricular (LV) mass and left atrial volume indexed to height2.7 in both men and women (P<0.001). In women, all three measures were associated with abnormal LV geometry, and increasing WC and BF were associated with worse global longitudinal strain, a measure of left ventricular systolic function. In both sexes, increasing BMI was associated with greater right ventricular (RV) end-diastolic area and worse RV fractional area change (P≤0.001). We observed similar associations for both waist circumference and percent body fat. In a large, biracial cohort of older adults free of clinically overt coronary heart disease or heart failure, obesity was associated with subclinical abnormalities in cardiac structure in both men and women and with adverse left ventricular remodeling and impaired left ventricular systolic function in women. These data highlight the association of obesity and subclinical abnormalities of cardiac structure and function, particularly in women.