Subclinical alterations in left ventricular structure and function according to obesity and metabolic health status
Autoři:
Hyun-Jung Lee aff001; Hack-Lyoung Kim aff001; Woo-Hyun Lim aff001; Jae-Bin Seo aff001; Sang-Hyun Kim aff001; Joo-Hee Zo aff001; Myung-A. Kim aff001
Působiště autorů:
Division of Cardiology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Boramae Medical Center, Seoul, Korea
aff001
Vyšlo v časopise:
PLoS ONE 14(9)
Kategorie:
Research Article
doi:
https://doi.org/10.1371/journal.pone.0222118
Souhrn
Background
Obesity and metabolic syndrome (MetS) are associated with high risk of cardiac dysfunction and heart failure. We assessed the effect of obesity and metabolic health status on left ventricular (LV) structure and function in subjects without overt heart disease.
Methods
In 789 subjects (58.8±13.0 years, 50.7% males) without overt heart disease, LV morphology and function were compared among 6 groups stratified by body mass index (BMI) (normal weight, overweight and obese) and metabolic health status (meeting ≤1 criterion of MetS excluding waist circumference defined as metabolically healthy; otherwise, metabolically unhealthy).
Results
LV ejection fraction (LVEF) was not different among the 6 groups (P>0.05). However, high BMI and poor metabolic health were associated with poorer global longitudinal strain (GLS), higher LV mass index (LVMI) and higher E/e′ (P<0.001). Poor metabolic health status was associated with greater adverse changes in LV structure and function than obesity, and among MetS components, high systolic blood pressure (SBP) showed the greatest impact. Higher SBP, BMI and triglycerides were independently associated with worse GLS, and higher SBP was also associated with worse LVMI and E/e´. GLS, LVMI and E/e´ worsened in proportion to the number of MetS criteria or continuous MetS scores. Adverse myocardial changes associated with obesity were significant in the metabolically healthy group, but not in the metabolically unhealthy group.
Conclusions
Obesity and poor metabolic health status were associated with subclinical decrement in LV systolic and diastolic function, and higher LV mass, but not with LVEF, in subjects without overt heart disease.
Klíčová slova:
Biology and life sciences – Physiology – Physiological parameters – Obesity – Biochemistry – Lipids – Cholesterol – Metabolism – Carbohydrate metabolism – Glucose metabolism – Medicine and health sciences – Body weight – Body Mass Index – Diagnostic medicine – Diagnostic radiology – Echocardiography – Radiology and imaging – Pharmacology – Pharmacokinetics – Drug metabolism – Vascular medicine – Blood pressure – Cardiovascular medicine – Cardiovascular diseases – Research and analysis methods – Imaging techniques – Ultrasound imaging
Zdroje
1. Kenchaiah S, Evans JC, Levy D, Wilson PW, Benjamin EJ, Larson MG, et al. Obesity and the risk of heart failure. N Engl J Med. 2002;347(5):305–13. doi: 10.1056/NEJMoa020245 12151467
2. Hubert HB, Feinleib M, McNamara PM, Castelli WP. Obesity as an independent risk factor for cardiovascular disease: a 26-year follow-up of participants in the Framingham Heart Study. Circulation. 1983;67(5):968–77. doi: 10.1161/01.cir.67.5.968 6219830
3. Lavie CJ, Alpert MA, Arena R, Mehra MR, Milani RV, Ventura HO. Impact of obesity and the obesity paradox on prevalence and prognosis in heart failure. JACC Heart Fail. 2013;1(2):93–102. doi: 10.1016/j.jchf.2013.01.006 24621833
4. Perrone-Filardi P, Paolillo S, Costanzo P, Savarese G, Trimarco B, Bonow RO. The role of metabolic syndrome in heart failure. Eur Heart J. 2015;36(39):2630–4. doi: 10.1093/eurheartj/ehv350 26242711
5. Tang ZH, Wang L, Zeng F, Zhang K. Association and predictive value analysis for metabolic syndrome on systolic and diastolic heart failure in high-risk patients. BMC Cardiovasc Disord. 2014;14:124. doi: 10.1186/1471-2261-14-124 25249273
6. Arnlov J, Ingelsson E, Sundstrom J, Lind L. Impact of body mass index and the metabolic syndrome on the risk of cardiovascular disease and death in middle-aged men. Circulation. 2010;121(2):230–6. doi: 10.1161/CIRCULATIONAHA.109.887521 20038741
7. Russo C, Jin Z, Elkind MS, Rundek T, Homma S, Sacco RL, et al. Prevalence and prognostic value of subclinical left ventricular systolic dysfunction by global longitudinal strain in a community-based cohort. Eur J Heart Fail. 2014;16(12):1301–9. doi: 10.1002/ejhf.154 25211239
8. Yang H, Negishi K, Wang Y, Nolan M, Saito M, Marwick TH. Echocardiographic screening for non-ischaemic stage B heart failure in the community. Eur J Heart Fail. 2016;18(11):1331–9. doi: 10.1002/ejhf.643 27813300
9. Haugaa KH, Dejgaard LA. Global Longitudinal Strain: Ready for Clinical Use and Guideline Implementation. J Am Coll Cardiol. 2018;71(18):1958–9. doi: 10.1016/j.jacc.2018.03.015 29724347
10. Wong CY, O'Moore-Sullivan T, Leano R, Byrne N, Beller E, Marwick TH. Alterations of left ventricular myocardial characteristics associated with obesity. Circulation. 2004;110(19):3081–7. doi: 10.1161/01.CIR.0000147184.13872.0F 15520317
11. Alpert MA, Lavie CJ, Agrawal H, Aggarwal KB, Kumar SA. Obesity and heart failure: epidemiology, pathophysiology, clinical manifestations, and management. Transl Res. 2014;164(4):345–56. doi: 10.1016/j.trsl.2014.04.010 24814682
12. Bello NA, Cheng S, Claggett B, Shah AM, Ndumele CE, Roca GQ, et al. Association of Weight and Body Composition on Cardiac Structure and Function in the ARIC Study (Atherosclerosis Risk in Communities). Circ Heart Fail. 2016;9(8).
13. Dini FL, Fabiani I, Miccoli M, Galeotti GG, Pugliese NR, D'Agostino A, et al. Prevalence and determinants of left ventricular diastolic dysfunction in obese subjects and the role of left ventricular global longitudinal strain and mass normalized to height. Echocardiography. 2018;35(8):1124–31. doi: 10.1111/echo.13890 29664200
14. Mahmud A, Almuntaser I, Brown A, King G, Crean P, Feely J. Left ventricular structural and functional changes in the metabolic syndrome. J Cardiometab Syndr. 2009;4(2):81–8. doi: 10.1111/j.1559-4572.2008.00043.x 19614794
15. Masugata H, Senda S, Goda F, Yoshihara Y, Yoshikawa K, Fujita N, et al. Left ventricular diastolic dysfunction as assessed by echocardiography in metabolic syndrome. Hypertens Res. 2006;29(11):897–903. doi: 10.1291/hypres.29.897 17345790
16. Crendal E, Walther G, Vinet A, Dutheil F, Naughton G, Lesourd B, et al. Myocardial deformation and twist mechanics in adults with metabolic syndrome: impact of cumulative metabolic burden. Obesity (Silver Spring). 2013;21(12):E679–86. doi: 10.1002/oby.20537 23804526
17. Hoang K, Zhao Y, Gardin JM, Carnethon M, Mukamal K, Yanez D, et al. LV Mass as a Predictor of CVD Events in Older Adults With and Without Metabolic Syndrome and Diabetes. JACC Cardiovasc Imaging. 2015;8(9):1007–15. doi: 10.1016/j.jcmg.2015.04.019 26319502
18. WHO, IASO. The Asia-Pacific perspective: redefining obesity and its treatment. Sydney; 2000.
19. Alberti KG, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, et al. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation. 2009;120(16):1640–5. doi: 10.1161/CIRCULATIONAHA.109.192644 19805654
20. Chamberlain JJ, Rhinehart AS, Shaefer CF Jr., Neuman A. Diagnosis and Management of Diabetes: Synopsis of the 2016 American Diabetes Association Standards of Medical Care in Diabetes. Ann Intern Med. 2016;164(8):542–52. doi: 10.7326/M15-3016 26928912
21. Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging. 2015;16(3):233–70. doi: 10.1093/ehjci/jev014 25712077
22. Nagueh SF, Smiseth OA, Appleton CP, Byrd BF 3rd, Dokainish H, Edvardsen T, et al. Recommendations for the Evaluation of Left Ventricular Diastolic Function by Echocardiography: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2016;29(4):277–314. doi: 10.1016/j.echo.2016.01.011 27037982
23. Voigt JU, Pedrizzetti G, Lysyansky P, Marwick TH, Houle H, Baumann R, et al. Definitions for a common standard for 2D speckle tracking echocardiography: consensus document of the EACVI/ASE/Industry Task Force to standardize deformation imaging. J Am Soc Echocardiogr. 2015;28(2):183–93. doi: 10.1016/j.echo.2014.11.003 25623220
24. Lee CS, Cha RH, Lim YH, Kim H, Song KH, Gu N, et al. Ethnic coefficients for glomerular filtration rate estimation by the Modification of Diet in Renal Disease study equations in the Korean population. J Korean Med Sci. 2010;25(11):1616–25. doi: 10.3346/jkms.2010.25.11.1616 21060751
25. Eisenmann JC. On the use of a continuous metabolic syndrome score in pediatric research. Cardiovasc Diabetol. 2008;7:17. doi: 10.1186/1475-2840-7-17 18534019
26. Okosun IS, Boltri JM, Lyn R, Davis-Smith M. Continuous metabolic syndrome risk score, body mass index percentile, and leisure time physical activity in American children. J Clin Hypertens (Greenwich). 2010;12(8):636–44.
27. DeBoer MD, Filipp SL, Gurka MJ. Use of a Metabolic Syndrome Severity Z Score to Track Risk During Treatment of Prediabetes: An Analysis of the Diabetes Prevention Program. Diabetes Care. 2018;41(11):2421–30. doi: 10.2337/dc18-1079 30275282
28. Gurka MJ, Lilly CL, Oliver MN, DeBoer MD. An examination of sex and racial/ethnic differences in the metabolic syndrome among adults: a confirmatory factor analysis and a resulting continuous severity score. Metabolism. 2014;63(2):218–25. doi: 10.1016/j.metabol.2013.10.006 24290837
29. Ersboll M, Valeur N, Mogensen UM, Andersen MJ, Moller JE, Velazquez EJ, et al. Prediction of all-cause mortality and heart failure admissions from global left ventricular longitudinal strain in patients with acute myocardial infarction and preserved left ventricular ejection fraction. J Am Coll Cardiol. 2013;61(23):2365–73. doi: 10.1016/j.jacc.2013.02.061 23563128
30. Stanton T, Leano R, Marwick TH. Prediction of all-cause mortality from global longitudinal speckle strain: comparison with ejection fraction and wall motion scoring. Circ Cardiovasc Imaging. 2009;2(5):356–64. doi: 10.1161/CIRCIMAGING.109.862334 19808623
31. Kalam K, Otahal P, Marwick TH. Prognostic implications of global LV dysfunction: a systematic review and meta-analysis of global longitudinal strain and ejection fraction. Heart. 2014;100(21):1673–80. doi: 10.1136/heartjnl-2014-305538 24860005
32. Park JJ, Park JB, Park JH, Cho GY. Global Longitudinal Strain to Predict Mortality in Patients With Acute Heart Failure. J Am Coll Cardiol. 2018;71(18):1947–57. doi: 10.1016/j.jacc.2018.02.064 29724346
33. Wang YC, Liang CS, Gopal DM, Ayalon N, Donohue C, Santhanakrishnan R, et al. Preclinical Systolic and Diastolic Dysfunctions in Metabolically Healthy and Unhealthy Obese Individuals. Circ Heart Fail. 2015;8(5):897–904. doi: 10.1161/CIRCHEARTFAILURE.114.002026 26175540
34. Dobson R, Burgess MI, Sprung VS, Irwin A, Hamer M, Jones J, et al. Metabolically healthy and unhealthy obesity: differential effects on myocardial function according to metabolic syndrome, rather than obesity. Int J Obes (Lond). 2016;40(1):153–61.
35. Ho JE, McCabe EL, Wang TJ, Larson MG, Levy D, Tsao C, et al. Cardiometabolic Traits and Systolic Mechanics in the Community. Circ Heart Fail. 2017;10(5).
36. Lee HJ, Kim HL, Chung J, Lim WH, Seo JB, Kim SH, et al. Interaction of Metabolic Health and Obesity on Subclinical Target Organ Damage. Metab Syndr Relat Disord. 2018;16(1):46–53. doi: 10.1089/met.2017.0078 29319402
Článek vyšel v časopise
PLOS One
2019 Číslo 9
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