Mandry Damien, Girerd Nicolas, Lamiral Zohra, Huttin Olivier, Filippetti Laura, Micard Emilien, Ncho Mottoh Marie-Paule Bernadette, Böhme Philip, Chemla Denis, Zannad Faïez, Rossignol Patrick, Marie Pierre-Yves
Department of Radiology, CHRU-Nancy, Université de Lorraine, Nancy, France.
INSERM, UMR-1254, Université de Lorraine, Nancy, France.
Front Cardiovasc Med. 2021 Nov 5;8:771022. doi: 10.3389/fcvm.2021.771022. eCollection 2021.
This study aims to assess the changes in cardiovascular remodeling attributable to bodyweight gain in a middle-aged abdominal obesity cohort. A remodeling worsening might explain the increase in cardiovascular risk associated with a dynamic of weight gain. Seventy-five middle-aged subjects (56 ± 5 years, 38 women) with abdominal obesity and no known cardiovascular disease underwent MRI-based examinations at baseline and at a 6.1 ± 1.2-year follow-up to monitor cardiovascular remodeling and hemodynamic variables, most notably the effective arterial elastance (Ea). Ea is a proxy of the arterial load that must be overcome during left ventricular (LV) ejection, with increased EA resulting in concentric LV remodeling. Sixteen obese subjects had significant weight gain (>7%) during follow-up (WG+), whereas the 59 other individuals did not (WG-). WG+ and WG- exhibited significant differences in the baseline to follow-up evolutions of several hemodynamic parameters, notably diastolic and mean blood pressures (for mean blood pressure, WG+: +9.3 ± 10.9 mmHg vs. WG-: +1.7 ± 11.8 mmHg, p = 0.022), heart rate (WG+: +0.6 ± 9.4 min vs. -8.9 ± 11.5 min, = 0.003), LV concentric remodeling index (WG: +0.08 ± 0.16 g.mL vs. WG-: -0.02 ± 0.13 g.mL, = 0.018) and Ea (WG+: +0.20 ± 0.28 mL mmHg vs. WG-: +0.01 ± 0.30 mL mmHg, = 0.021). The evolution of the LV concentric remodeling index and Ea were also strongly correlated in the overall obese population ( < 0.001, R = 0.31). A weight gain dynamic is accompanied by increases in arterial load and load-related concentric LV remodeling in an isolated abdominal obesity cohort. This remodeling could have a significant impact on cardiovascular risk.
本研究旨在评估中年腹型肥胖队列中体重增加所致的心血管重塑变化。重塑恶化可能解释了与体重增加动态相关的心血管风险增加。75名中年腹型肥胖且无已知心血管疾病的受试者(年龄56±5岁,女性38名)在基线时以及6.1±1.2年的随访时接受了基于MRI的检查,以监测心血管重塑和血流动力学变量,最显著的是有效动脉弹性(Ea)。Ea是左心室(LV)射血过程中必须克服的动脉负荷的一个指标,Ea增加会导致LV向心性重塑。16名肥胖受试者在随访期间体重显著增加(>7%)(WG+),而其他59人则没有(WG-)。WG+和WG-在几个血流动力学参数从基线到随访的变化上存在显著差异,尤其是舒张压和平均血压(平均血压,WG+:+9.3±10.9 mmHg vs. WG-:+1.7±11.8 mmHg,p = 0.022)、心率(WG+:+0.6±9.4次/分钟 vs. -8.9±11.5次/分钟,p = 0.003)、LV向心性重塑指数(WG+:+0.08±0.16 g/mL vs. WG-:-0.02±0.13 g/mL,p = 0.018)和Ea(WG+:+0.20±0.28 mL/mmHg vs. WG-:+0.01±0.30 mL/mmHg,p = 0.021)。在整个肥胖人群中,LV向心性重塑指数和Ea的变化也密切相关(p<0.001,R = 0.31)。在单纯腹型肥胖队列中,体重增加动态伴随着动脉负荷增加以及与负荷相关的LV向心性重塑。这种重塑可能对心血管风险产生重大影响。