Nitin Kondamudi1, Neela Thangada2, Kershaw V Patel3, Colby Ayers4, Alvin Chandra1, Jarret D Berry1, Ian J Neeland5, Ambarish Pandey6. 1. Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-9047, USA. 2. Division of Cardiology, Department of Internal Medicine, Northwestern University, Feinberg School of Medicine, Chicago, IL, 60611, USA. 3. Division of Cardiology, Department of Internal Medicine, Houston Methodist Hospital, 6550 Fannin St., Houston, TX, 77030, USA. 4. Department of Clinical Sciences, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-9047, USA. 5. Division of Cardiology, Department of Internal Medicine, University Hospitals Harrington Heart and Vascular Institute and Case Western Reserve University School of Medicine, 2103 Cornell Road, Cleveland, OH, 44106, USA. 6. Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-9047, USA. ambarish.pandey@outlook.edu.
Abstract
BACKGROUND: Low cardiorespiratory fitness (CRF), high body mass index, and excess visceral adiposity are each associated with impairment in left ventricular (LV) peak circumferential strain (Ecc), an intermediate phenotype that precedes the development of clinical heart failure (HF). However, the association of regional fat distribution and CRF with Ecc independent of each other and other potential confounders is not known. METHODS: Participants from the Dallas Heart Study Phase 2 who underwent dual energy X-ray absorptiometry assessment of regional fat distribution, CRF assessment by submaximal treadmill test, and Ecc quantification by tissue-tagged cardiovascular magnetic resonance were included in the analysis. The cross-sectional associations of measures of regional adiposity, namely visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and lower-body fat (LBF) with Ecc after adjustment for CRF and other potential confounders (independent variables) were assessed using multivariable linear regression analysis. RESULTS: The study included 1089 participants (55% female, 39% black). In the unadjusted analysis, higher VAT was associated with greater impairment in Ecc. After adjustment for baseline risk factors, CRF, parameters of LV structure and function, and other fat depots such as SAT and LBF, higher VAT remained associated with greater impairment in Ecc (β: 0.19, P = 0.002). SAT and LBF were not significantly associated with Ecc, however, CRF remained associated with Ecc in the fully adjusted model including all fat depots (β: - 0.15, P < 0.001). CONCLUSIONS: VAT and CRF are each independently associated with impairment in Ecc, suggesting that higher VAT burden and low CRF mediate pathological cardiac remodeling through distinct mechanisms.
BACKGROUND:Low cardiorespiratory fitness (CRF), high body mass index, and excess visceral adiposity are each associated with impairment in left ventricular (LV) peak circumferential strain (Ecc), an intermediate phenotype that precedes the development of clinical heart failure (HF). However, the association of regional fat distribution and CRF with Ecc independent of each other and other potential confounders is not known. METHODS:Participants from the Dallas Heart Study Phase 2 who underwent dual energy X-ray absorptiometry assessment of regional fat distribution, CRF assessment by submaximal treadmill test, and Ecc quantification by tissue-tagged cardiovascular magnetic resonance were included in the analysis. The cross-sectional associations of measures of regional adiposity, namely visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and lower-body fat (LBF) with Ecc after adjustment for CRF and other potential confounders (independent variables) were assessed using multivariable linear regression analysis. RESULTS: The study included 1089 participants (55% female, 39% black). In the unadjusted analysis, higher VAT was associated with greater impairment in Ecc. After adjustment for baseline risk factors, CRF, parameters of LV structure and function, and other fat depots such as SAT and LBF, higher VAT remained associated with greater impairment in Ecc (β: 0.19, P = 0.002). SAT and LBF were not significantly associated with Ecc, however, CRF remained associated with Ecc in the fully adjusted model including all fat depots (β: - 0.15, P < 0.001). CONCLUSIONS: VAT and CRF are each independently associated with impairment in Ecc, suggesting that higher VAT burden and low CRF mediate pathological cardiac remodeling through distinct mechanisms.
Authors: Ambarish Pandey; Nitin Kondamudi; Kershaw V Patel; Colby Ayers; Shawn Simek; Michael E Hall; Solomon K Musani; Chad Blackshear; Robert J Mentz; Hassan Khan; James G Terry; Adolfo Correa; Javed Butler; Ian J Neeland; Jarett D Berry Journal: Circ Heart Fail Date: 2018-11 Impact factor: 8.790
Authors: Ambarish Pandey; Minesh Patel; Ang Gao; Benjamin L Willis; Sandeep R Das; David Leonard; Mark H Drazner; James A de Lemos; Laura DeFina; Jarett D Berry Journal: Am Heart J Date: 2014-11-12 Impact factor: 4.749
Authors: Stephanie K Brinker; Ambarish Pandey; Colby R Ayers; Carolyn E Barlow; Laura F DeFina; Benjamin L Willis; Nina B Radford; Ramin Farzaneh-Far; James A de Lemos; Mark H Drazner; Jarett D Berry Journal: JACC Heart Fail Date: 2014-04-30 Impact factor: 12.035
Authors: S A Abbasi; W G Hundley; D A Bluemke; M Jerosch-Herold; R Blankstein; Steffen E Petersen; Oliver J Rider; J A C Lima; M A Allison; V L Murthy; R V Shah Journal: Nutr Metab Cardiovasc Dis Date: 2015-04-16 Impact factor: 4.222
Authors: Ian J Neeland; Sachin Gupta; Colby R Ayers; Aslan T Turer; J Eduardo Rame; Sandeep R Das; Jarett D Berry; Amit Khera; Darren K McGuire; Gloria L Vega; Scott M Grundy; James A de Lemos; Mark H Drazner Journal: Circ Cardiovasc Imaging Date: 2013-08-08 Impact factor: 7.792
Authors: Ambarish Pandey; Michael LaMonte; Liviu Klein; Colby Ayers; Bruce M Psaty; Charles B Eaton; Norrina B Allen; James A de Lemos; Mercedes Carnethon; Philip Greenland; Jarett D Berry Journal: J Am Coll Cardiol Date: 2017-03-07 Impact factor: 24.094
Authors: Satish Kenchaiah; Jane C Evans; Daniel Levy; Peter W F Wilson; Emelia J Benjamin; Martin G Larson; William B Kannel; Ramachandran S Vasan Journal: N Engl J Med Date: 2002-08-01 Impact factor: 91.245
Authors: Ambarish Pandey; Sanjiv J Shah; Javed Butler; Dean L Kellogg; Gregory D Lewis; Daniel E Forman; Robert J Mentz; Barry A Borlaug; Marc A Simon; Julio A Chirinos; Roger A Fielding; Elena Volpi; Anthony J A Molina; Mark J Haykowsky; Flora Sam; Bret H Goodpaster; Alain G Bertoni; Jamie N Justice; James P White; Jingzhone Ding; Scott L Hummel; Nathan K LeBrasseur; George E Taffet; Iraklis I Pipinos; Dalane Kitzman Journal: J Am Coll Cardiol Date: 2021-09-14 Impact factor: 27.203