Visceral adiposity, muscle composition, and exercise tolerance in heart failure with preserved ejection fraction.
Visceral adiposity, muscle composition, and exercise tolerance in heart failure with preserved ejection fraction.
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DOI：
10.1002/ehf2.13382
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发表时间：
2021-08
影响因子：
3.8
通讯作者：
Hays AG
中科院分区：
文献类型：
--
作者：
Ying W;Sharma K;Yanek LR;Vaidya D;Schär M;Markl M;Subramanya V;Soleimani S;Ouyang P;Michos ED;Shah SJ;Hays AG
内脏脂肪组织(AT)促进炎症，并可能与射血分数(HFpEF)保留的心力衰竭的疾病进展有关。我们研究了HFpEF患者和对照组的地区性AT分布，并分析了其与合并症和运动耐量的关系。磁共振成像被用来量化心外膜、肝脏、腹部和大腿骨骼肌AT。我们评估了纽约心脏协会(NYHA)分级、6分钟步行距离和全球幸福感评分。采用调整体表面积的多元线性回归模型。我们研究了55例HFpEF患者(41例女性，平均年龄67±11.0岁)和33例对照组(21例女性，平均年龄57±11.0岁)。心外膜AT(中位数为4.6vs.3.2[1.4]mm，P=0.001)、大腿肌间脂肪(11.0vs.5.0[2.7cm2，P=0.001)和肝脏脂肪分数(6.4%vs.4.1%[5.5vs.4.1%(P=0.001)]均高于对照组。女性HFpEF的腹部和大腿皮下AT高于男性。大腿肌肉间脂肪较大与较高的血压(β[SE]0.73[0.17]，P<0.001)和糖尿病(优势比[95%可信区间]1.2[1.0-1.5]，P=0.03)相关。较大的大腿肌内脂肪与较差的NYHA分级(β[SE]2.7[1]，P=0.0 1)和较短的6分钟步行距离(β[SE]−4.1[1.9]，P=0.0 3)、较大的心外膜AT(β[SE]−0.2[0.1]，P=0.001)和肝脏脂肪分数(β[SE]−0.4[0.2]，P=0.0 4)相关。与对照组相比，射血分数保留的心力衰竭患者心外膜、肝脏和骨骼肌脂肪的增加与他们增加的身体尺寸不成比例，肥胖与HFpEF的NYHA分级和运动耐量较差相关。这些结果为进一步研究干预措施减少局部AT分布与HFpEF症状和病理生理学的关系提供了基础。
Visceral adipose tissue (AT) promotes inflammation and may be associated with disease progression in heart failure with preserved ejection fraction (HFpEF). We characterized regional AT distribution in HFpEF patients and controls and analysed associations with co‐morbidities and exercise tolerance. Magnetic resonance imaging was performed to quantify epicardial, liver, abdominal, and thigh skeletal muscle AT. We assessed New York Heart Association (NYHA) class, 6 min walk distance, and global well‐being score. Multivariable linear regression models adjusting for body surface area were used. We studied 55 HFpEF patients (41 women, mean age 67 ± 11 years) and 33 controls (21 women, mean age 57 ± 10 years). Epicardial AT (median [interquartile range] 4.6 [2.0] vs. 3.2 [1.4] mm, P < 0.001), thigh intermuscular fat (11.0 [11.5] vs. 5.0 [2.7] cm2, P < 0.001) and liver fat fraction (6.4% [6.1] vs. 4.1% [5.5], P = 0.001) were higher in HFpEF patients than controls. Women with HFpEF had higher abdominal and thigh subcutaneous AT than men. Greater thigh intermuscular fat was associated with higher blood pressure (β [SE] 0.73 [0.17], P < 0.001) and diabetes (odds ratio [95% confidence interval] 1.2 [1.0–1.5], P = 0.03). Greater thigh intramuscular fat was associated with both worse NYHA class (β [SE] 2.7 [1.0], P = 0.01) and shorter 6 min walk distance (β [SE] −4.1 [1.9], P = 0.03), and greater epicardial AT (β [SE] −0.2 [0.1], P < 0.001) and liver fat fraction (β [SE] −0.4 [0.2], P = 0.04) were associated with lower global well‐being score. Heart failure with preserved ejection fraction patients have increased epicardial, liver, and skeletal muscle fat compared with controls out of proportion to their increased body size, and adiposity was associated with worse NYHA class and exercise tolerance in HFpEF. These results provide the basis for further investigation into the effect of interventions to reduce regional AT distribution in relation to HFpEF symptoms and pathophysiology.
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影响因子：
20.1
作者：
Sharma K;Kass DA
通讯作者：
Kass DA
影响因子：
37.8
作者：
Neeland IJ;Poirier P;Després JP
通讯作者：
Després JP
影响因子：
4.4
作者：
Karampinos, Dimitrios C.;Baum, Thomas;Majumdar, Sharmila
通讯作者：
Majumdar, Sharmila
影响因子：
2.8
作者：
Haykowsky, Mark J.;Kouba, Erik J.;Brubaker, Peter H.;Nicklas, Barbara J.;Eggebeen, Joel;Kitzman, Dalane W.
通讯作者：
Kitzman, Dalane W.
影响因子：
39.2
作者：
Levey AS;Stevens LA;Schmid CH;Zhang YL;Castro AF 3rd;Feldman HI;Kusek JW;Eggers P;Van Lente F;Greene T;Coresh J;CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration)
通讯作者：
CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration)