Relation of regional fat distribution to left ventricular structure and function.
Relation of regional fat distribution to left ventricular structure and function.
复制标题
DOI：
10.1161/circimaging.113.000532
复制
发表时间：
2013-09
期刊：
影响因子：
--
通讯作者：
Drazner MH
中科院分区：
文献类型：
--
作者：
Neeland IJ;Gupta S;Ayers CR;Turer AT;Rame JE;Das SR;Berry JD;Khera A;McGuire DK;Vega GL;Grundy SM;de Lemos JA;Drazner MH
体脂分布与左心室(LV)结构和功能的关系尚不清楚。在达拉斯心脏研究中，2710名没有心力衰竭或左心功能不全的参与者接受了双能量X射线吸收测量仪和磁共振成像，以评估脂肪分布、左室形态和血流动力学。在调整了年龄、性别、种族、合并症和瘦体重后，检查了脂肪分布与左心室结构和功能的横断面相关性。平均年龄为44岁，其中55%为女性；48%为非裔美国人；44%为肥胖者。多变量调整后，内脏脂肪(VAT)与向心性重构相关，表现为较低的左心室舒张末容量(β=-0.2 1)、较高的向心度(β=0.2)和较高的室壁厚度(β=0.09，p<；0.0001)。相反，下半身皮下脂肪与较高的LV舒张末容量(β=0.48)、较低的向心度(β=-0.5)和较厚的室壁厚度(β=-0.28，p<；0.0001)相关。VAT还与较低的心输出量(β=-0.10，p<；0.05)和较高的全身血管阻力(β=0.08，p&t；0.05)有关，而下体血流量与较高的心输出量(β=0.2，p和t；0.0001)和较低的全身血管阻力(β=-0.18，p和t；0.0001)有关。腹部皮下脂肪(SAT)与向心性重塑的相关性较弱，与血流动力学无关。在肥胖参与者的子组中，VAT，而不是SAT，与向心性重构显著相关。VAT是中心性肥胖的标志，与向心性左室重构和不利的血流动力学独立相关。相反，LBF与偏心性重构有关。体脂分布对心力衰竭风险的影响需要进行前瞻性研究。
The relation of body fat distribution to left ventricular (LV) structure and function is poorly defined. 2710 participants without heart failure or LV dysfunction in the Dallas Heart Study underwent dual energy x-ray absorptiometry and magnetic resonance imaging 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% African-Americans; and 44% obese. After multivariable adjustment, visceral fat (VAT) was associated with concentric remodeling characterized by lower LV end-diastolic volume (β= -0.21), higher concentricity (β= 0.20) and wall thickness (β=0.09, p<0.0001 for all). In contrast, lower body subcutaneous fat (LBF) was associated with higher LV end-diastolic volume (β= 0.48), reduced concentricity (β= -0.50) and wall thickness (β= -0.28, p<0.0001 for all). VAT was also associated with lower cardiac output (β= -0.10, p<0.05) and higher systemic vascular resistance (β= 0.08, p<0.05) whereas LBF associated with higher cardiac output (β= 0.20, p<0.0001) and lower systemic vascular resistance (β= -0.18, p<0.0001). Abdominal subcutaneous fat (SAT) showed weaker associations with concentric remodeling and was not associated with hemodynamics. Among the subset of obese participants, VAT, but not SAT, was significantly associated with concentric remodeling. VAT, a marker of central adiposity, was independently associated with concentric LV remodeling and adverse hemodynamics. In contrast, LBF was associated with eccentric remodeling. The impact of body fat distribution on heart failure risk requires prospective study.