Central Obesity is Associated with Increased Left Ventricular Maximal Wall Thickness and Intrathoracic Adipose Tissue Measured with Cardiac Magnetic Resonance

• Published in: High Blood Pressure & Cardiovascular Prevention Vol. 31; no. 4; pp. 389 - 399
• Main Authors: Marttila, Jarkko, Sipola, Petri, Juutilainen, Auni, Sillanmäki, Saara, Hedman, Marja, Kuusisto, Johanna
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.07.2024; Springer Nature B.V
• Subjects: Adipose Tissue - diagnostic imaging; Adipose Tissue - physiopathology; Adiposity; Adult; Blood pressure; Body fat; Body Mass Index; Cardiology; Cardiovascular disease; Case-Control Studies; Cross-Sectional Studies; Diabetes; Glucose; Health risks; Heart; Humans; Hypertension; Hypertrophy, Left Ventricular - diagnostic imaging; Hypertrophy, Left Ventricular - etiology; Hypertrophy, Left Ventricular - physiopathology; Magnetic Resonance Imaging; Magnetic Resonance Imaging, Cine; Male; Medicine; Medicine & Public Health; Metabolic syndrome; Middle Aged; Mortality; Obesity; Obesity, Abdominal - complications; Obesity, Abdominal - diagnostic imaging; Obesity, Abdominal - physiopathology; Original; Original Article; Pharmacotherapy; Predictive Value of Tests; Software; Ventricular Function, Left; Ventricular Remodeling; Waist Circumference; Germany; Intrathoracic adipose tissue; Cardiovascular magnetic resonance; Left ventricular wall thickness; Waist-to-hip ratio; Central obesity; Left ventricular hypertrophy
• ISSN: 1120-9879; 1179-1985
• DOI: 10.1007/s40292-024-00659-9

Introduction Central obesity (CO), characterized by an increased waist circumference increases the risk of cardiovascular disease (CVD) and morbidity, yet the underlying mechanisms are not fully understood. CO is often associated with general obesity, hypertension, and abnormal glucose tolerance, confounding the independent contribution of CO to CVD. Aim We investigated the relationship of CO (without associated disorders) with left ventricular (LV) characteristics and intrathoracic adipose tissue (IAT) by cardiac magnetic resonance. Methods LV characteristics, epicardial (EAT), and mediastinal adipose tissue (MAT) were measured from 29 normoglycemic, normotensive males with CO but without general obesity (waist circumference >100 cm, body mass index (BMI) <30 kg/m 2 ) and 18 non-obese male controls. Results LV maximal wall thickness (LVMWT) and IAT but not LV mass or volumes were increased in CO subjects compared to controls (LVMWT, 12.3±1.2 vs. 10.7±1.5 mm, p < 0.001; EAT, 5.5±3.0 vs. 2.2±2.0 cm 2 , p = 0.001; MAT, 31.0±12.8 vs. 15.4±10.7 cm 2 , p < 0.001). The LVMWT was ≥12 mm in 69% of subjects with CO and 22% of controls ( p = 0.002). In CO suspects, EAT correlated inversely with LV end-diastolic volume index ( r = − 0.403, p = 0.037) and LV stroke volume (SV) (r = − 0.425, p = 0.027). MAT correlated inversely with SV ( r = − 0.427, p =0.026) and positively with LVMWT ( r = 0.399, p = 0.035). Among CO subjects, the waist-to-hip ratio (WHR) was an independent predictor of LVMWT (B = 22.4, β = 0.617, p < 0.001). The optimal cut-off with Youden’s index for LV hypertrophy was identified at WHR 0.98 (sensitivity 85%, specificity 89%). Conclusions CO independent of BMI is associated with LV hypertrophy and intrathoracic adipose tissue contributing to cardiovascular burden.