区域性肥胖、心肺适能与左心室应变：来自达拉斯心脏研究的分析。
Regional adiposity, cardiorespiratory fitness, and left ventricular strain: an analysis from the Dallas Heart Study.
机构信息
Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-9047, USA.
Division of Cardiology, Department of Internal Medicine, Northwestern University, Feinberg School of Medicine, Chicago, IL, 60611, USA.
出版信息
J Cardiovasc Magn Reson. 2021 Jun 14;23(1):78. doi: 10.1186/s12968-021-00757-w.
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 (E), an intermediate phenotype that precedes the development of clinical heart failure (HF). However, the association of regional fat distribution and CRF with E 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 E 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 E 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 E. 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 E (β: 0.19, P = 0.002). SAT and LBF were not significantly associated with E, however, CRF remained associated with E 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 E, suggesting that higher VAT burden and low CRF mediate pathological cardiac remodeling through distinct mechanisms.
背景
低心肺适能（CRF）、高体重指数和过多内脏脂肪均与左心室（LV）峰值周向应变（E）受损有关，E 是一种中间表型，先于临床心力衰竭（HF）的发生。然而，区域性脂肪分布与 CRF 彼此独立且与其他潜在混杂因素相关联，与 E 的关系尚不清楚。
方法
纳入达拉斯心脏研究第二阶段参与者，他们接受了双能 X 射线吸收法评估区域性脂肪分布、次最大跑步机测试评估 CRF 以及组织标记心血管磁共振评估 E。在调整 CRF 和其他潜在混杂因素（自变量）后，使用多变量线性回归分析评估区域性肥胖指标（即内脏脂肪组织[VAT]、皮下脂肪组织[SAT]和下半身脂肪[LBF]）与 E 的横断面相关性。
结果
这项研究纳入了 1089 名参与者（55%为女性，39%为黑人）。在未调整的分析中，较高的 VAT 与 E 的损害程度增加相关。在调整基线风险因素、CRF、LV 结构和功能参数以及其他脂肪沉积（如 SAT 和 LBF）后，较高的 VAT 与 E 的损害程度增加仍然相关（β：0.19，P=0.002）。然而，SAT 和 LBF 与 E 无显著相关性，但在包括所有脂肪沉积的完全调整模型中，CRF 仍与 E 相关（β：-0.15，P<0.001）。
结论
VAT 和 CRF 各自与 E 的损害程度独立相关，这表明较高的 VAT 负担和较低的 CRF 通过不同的机制介导病理性心脏重构。
Zotero 插件