Patel Vivek G, Gupta Deepak K, Terry James G, Kabagambe Edmond K, Wang Thomas J, Correa Aldolfo, Griswold Michael, Taylor Herman, Carr John Jeffrey
Vanderbilt University School of Medicine, Nashville, Tennessee; Vanderbilt Translational and Clinical Cardiovascular Research Center, Nashville, Tennessee.
Vanderbilt University School of Medicine, Nashville, Tennessee; Vanderbilt Translational and Clinical Cardiovascular Research Center, Nashville, Tennessee.
JACC Heart Fail. 2017 Mar;5(3):182-190. doi: 10.1016/j.jchf.2016.12.020.
This study sought to assess whether body mass index (BMI) was associated with subclinical left ventricular (LV) systolic dysfunction in African-American individuals.
Higher BMI is a risk factor for cardiovascular disease, including heart failure. Obesity disproportionately affects African Americans; however, the association between higher BMI and LV function in African Americans is not well understood.
Peak systolic circumferential strain (ECC) was measured by tagged cardiac magnetic resonance in 1,652 adult African-American participants of the Jackson Heart Study between 2008 and 2012. We evaluated the association between BMI and ECC in multivariate linear regression and restricted cubic spline analyses adjusted for prevalent cardiovascular disease, conventional cardiovascular risk factors, LV mass, and ejection fraction. In exploratory analyses, we also examined whether inflammation, insulin resistance, or volume of visceral adipose tissue altered the association between BMI and ECC.
The proportions of female, nonsmokers, diabetic, and hypertensive participants rose with increase in BMI. In multivariate-adjusted models, higher BMI was associated with worse ECC (β = 0.052; 95% confidence interval: 0.028 to 0.075), even in the setting of preserved LV ejection fraction. Higher BMI was also associated with worse ECC when accounting for markers of inflammation (C-reactive protein, E-selection, and P-selectin), insulin resistance, and volume of visceral adipose tissue.
Higher BMI is significantly associated with subclinical LV dysfunction in African Americans, even in the setting of preserved LV ejection fraction.
本研究旨在评估体重指数（BMI）是否与非裔美国人的亚临床左心室（LV）收缩功能障碍相关。
较高的BMI是心血管疾病（包括心力衰竭）的危险因素。肥胖对非裔美国人的影响尤为严重；然而，较高的BMI与非裔美国人左心室功能之间的关联尚未完全明确。
在2008年至2012年期间，对杰克逊心脏研究中的1652名成年非裔美国参与者进行标记心脏磁共振成像测量其收缩期峰值圆周应变（ECC）。我们在多变量线性回归和受限立方样条分析中评估了BMI与ECC之间的关联，并对常见心血管疾病、传统心血管危险因素、左心室质量和射血分数进行了调整。在探索性分析中，我们还研究了炎症、胰岛素抵抗或内脏脂肪组织体积是否改变了BMI与ECC之间的关联。
女性、非吸烟者、糖尿病患者和高血压患者的比例随BMI的增加而上升。在多变量调整模型中，即使在左心室射血分数保留的情况下，较高的BMI也与较差的ECC相关（β = 0.052；95%置信区间：0.028至0.075）。在考虑炎症标志物（C反应蛋白、E选择素和P选择素）、胰岛素抵抗和内脏脂肪组织体积时，较高的BMI也与较差的ECC相关。
即使在左心室射血分数保留的情况下，较高的BMI也与非裔美国人的亚临床左心室功能障碍显著相关。
