Harjit Chahal1, Robyn L McClelland2, Harikrishna Tandri3, Aditya Jain1, Evrim B Turkbey4, W Gregory Hundley5, R Graham Barr6, Jorge Kizer7, João A C Lima3, David A Bluemke4, Steven M Kawut8. 1. Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD. 2. Department of Biostatistics, University of Washington, Seattle, WA. 3. Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD. 4. Department of Radiology and Imaging Sciences, National Institutes of Health/Clinical Center, National Institute of Biomedical Imaging and Bioengineering, Bethesda, MD. 5. Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC. 6. Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY. 7. Department of Medicine, Weill Cornell Medical College, New York, NY. 8. Penn Cardiovascular Institute, Department of Medicine, and Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Electronic address: kawut@upenn.edu.
Abstract
BACKGROUND: The relationship between obesity and right ventricular (RV) morphology is not well studied. We aimed to determine the association between obesity and RV structure and function in a large multiethnic population-based cohort. METHODS: The MESA-Right Ventricle Study measured RV mass and volumes by cardiac MRI in participants aged 45 to 84 years without clinical cardiovascular disease in the Multi-Ethnic Study of Atherosclerosis (MESA). Participants were divided into three categories based on BMI: lean ( ≤ 24.9 kg/m(2)), overweight (25-29.9 kg/m(2)), and obese ( ≥ 30 kg/m(2)). RESULTS: The study sample included 4,127 participants. After adjustment for demographics, height, education, and cardiovascular risk factors, overweight and obese participants had greater RV mass (6% and 9% greater, respectively), larger RV end-diastolic volume (8% and 18% greater, respectively), larger RV stroke volume (7% and 16% greater, respectively), and lower RV ejection fraction ( ≥ 1% lower) than lean participants (all P < .001). These findings persisted after adjusting for the respective left ventricular (LV) parameters. CONCLUSIONS: Overweight and obesity were independently associated with differences in RV morphology even after adjustment for the respective LV measure. This association could be explained by increased RV afterload, increased blood volume, hormonal effects, or direct obesity-related myocardial effects.
BACKGROUND: The relationship between obesity and right ventricular (RV) morphology is not well studied. We aimed to determine the association between obesity and RV structure and function in a large multiethnic population-based cohort. METHODS: The MESA-Right Ventricle Study measured RV mass and volumes by cardiac MRI in participants aged 45 to 84 years without clinical cardiovascular disease in the Multi-Ethnic Study of Atherosclerosis (MESA). Participants were divided into three categories based on BMI: lean ( ≤ 24.9 kg/m(2)), overweight (25-29.9 kg/m(2)), and obese ( ≥ 30 kg/m(2)). RESULTS: The study sample included 4,127 participants. After adjustment for demographics, height, education, and cardiovascular risk factors, overweight and obeseparticipants had greater RV mass (6% and 9% greater, respectively), larger RV end-diastolic volume (8% and 18% greater, respectively), larger RV stroke volume (7% and 16% greater, respectively), and lower RV ejection fraction ( ≥ 1% lower) than lean participants (all P < .001). These findings persisted after adjusting for the respective left ventricular (LV) parameters. CONCLUSIONS: Overweight and obesity were independently associated with differences in RV morphology even after adjustment for the respective LV measure. This association could be explained by increased RV afterload, increased blood volume, hormonal effects, or direct obesity-related myocardial effects.
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