Obesity and Right Ventricular Structure and Function: the MESA-Right Ventricle Study

Overview

Journal Chest

Publisher Elsevier

Specialty Pulmonary Medicine

Date 2011 Aug 27

PMID 21868467

Citations 52

Authors

Harjit Chahal

Robyn L McClelland

Harikrishna Tandri

Aditya Jain

Evrim B Turkbey

W Gregory Hundley

R Graham Barr

Jorge Kizer

Joao A C Lima

David A Bluemke

Steven M Kawut

Affiliations

Soon will be listed here.

Abstract

Background: The relationship between obesity and right ventricular (RV) morphology is not well studied. We aimed to determine the association between obesity and RV structure and function in a large multiethnic population-based cohort.

Methods: The MESA-Right Ventricle Study measured RV mass and volumes by cardiac MRI in participants aged 45 to 84 years without clinical cardiovascular disease in the Multi-Ethnic Study of Atherosclerosis (MESA). Participants were divided into three categories based on BMI: lean ( ≤ 24.9 kg/m(2)), overweight (25-29.9 kg/m(2)), and obese ( ≥ 30 kg/m(2)).

Results: The study sample included 4,127 participants. After adjustment for demographics, height, education, and cardiovascular risk factors, overweight and obese participants had greater RV mass (6% and 9% greater, respectively), larger RV end-diastolic volume (8% and 18% greater, respectively), larger RV stroke volume (7% and 16% greater, respectively), and lower RV ejection fraction ( ≥ 1% lower) than lean participants (all P < .001). These findings persisted after adjusting for the respective left ventricular (LV) parameters.

Conclusions: Overweight and obesity were independently associated with differences in RV morphology even after adjustment for the respective LV measure. This association could be explained by increased RV afterload, increased blood volume, hormonal effects, or direct obesity-related myocardial effects.

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References

Chahal H, Johnson C, Tandri H, Jain A, Hundley W, Barr R . Relation of cardiovascular risk factors to right ventricular structure and function as determined by magnetic resonance imaging (results from the multi-ethnic study of atherosclerosis). Am J Cardiol. 2010; 106(1):110-6. PMC: 2901248. DOI: 10.1016/j.amjcard.2010.02.022. View

Alpert M, Terry B, Kelly D . Effect of weight loss on cardiac chamber size, wall thickness and left ventricular function in morbid obesity. Am J Cardiol. 1985; 55(6):783-6. DOI: 10.1016/0002-9149(85)90156-0. View

Messerli F, Reisin E, Dreslinski G, Dunn F, Frohlich E . Disparate cardiovascular effects of obesity and arterial hypertension. Am J Med. 1983; 74(5):808-12. DOI: 10.1016/0002-9343(83)91071-9. View

McGavock J, Victor R, Unger R, Szczepaniak L . Adiposity of the heart, revisited. Ann Intern Med. 2006; 144(7):517-24. DOI: 10.7326/0003-4819-144-7-200604040-00011. View

Myerson S, Bellenger N, Pennell D . Assessment of left ventricular mass by cardiovascular magnetic resonance. Hypertension. 2002; 39(3):750-5. DOI: 10.1161/hy0302.104674. View

Alexander J . The cardiomyopathy of obesity. Prog Cardiovasc Dis. 1985; 27(5):325-34. DOI: 10.1016/s0033-0620(85)80002-5. View

Natori S, Lai S, Finn J, Gomes A, Hundley W, Jerosch-Herold M . Cardiovascular function in multi-ethnic study of atherosclerosis: normal values by age, sex, and ethnicity. AJR Am J Roentgenol. 2006; 186(6 Suppl 2):S357-65. DOI: 10.2214/AJR.04.1868. View

Lieb W, Sullivan L, Aragam J, Harris T, Roubenoff R, Benjamin E . Relation of serum leptin with cardiac mass and left atrial dimension in individuals >70 years of age. Am J Cardiol. 2009; 104(4):602-5. PMC: 2745631. DOI: 10.1016/j.amjcard.2009.04.026. View

Loehr L, Rosamond W, Poole C, McNeill A, Chang P, Folsom A . Association of multiple anthropometrics of overweight and obesity with incident heart failure: the Atherosclerosis Risk in Communities study. Circ Heart Fail. 2009; 2(1):18-24. PMC: 2748859. DOI: 10.1161/CIRCHEARTFAILURE.108.813782. View

10.

Shibata R, Ouchi N, Ito M, Kihara S, Shiojima I, Pimentel D . Adiponectin-mediated modulation of hypertrophic signals in the heart. Nat Med. 2004; 10(12):1384-9. PMC: 2828675. DOI: 10.1038/nm1137. View

11.

Imada M, Funabashi N, Asano M, Uehara M, Hori Y, Ueda M . Epidemiology of fat replacement of the right ventricular myocardium determined by multislice computed tomography using a logistic regression model. Int J Cardiol. 2006; 119(3):410-3. DOI: 10.1016/j.ijcard.2006.07.174. View

12.

Messerli F . Cardiovascular effects of obesity and hypertension. Lancet. 1982; 1(8282):1165-8. DOI: 10.1016/s0140-6736(82)92234-6. View

13.

Wong C, OMoore-Sullivan T, Leano R, Hukins C, Jenkins C, Marwick T . Association of subclinical right ventricular dysfunction with obesity. J Am Coll Cardiol. 2006; 47(3):611-6. DOI: 10.1016/j.jacc.2005.11.015. View

14.

Maniscalco M, Arciello A, Zedda A, Faraone S, Verde R, Giardiello C . Right ventricular performance in severe obesity. Effect of weight loss. Eur J Clin Invest. 2007; 37(4):270-5. DOI: 10.1111/j.1365-2362.2007.01783.x. View

15.

Willens H, Chakko S, Lowery M, Byers P, Labrador E, Gallagher A . Tissue Doppler imaging of the right and left ventricle in severe obesity (body mass index >35 kg/m2). Am J Cardiol. 2004; 94(8):1087-90. DOI: 10.1016/j.amjcard.2004.06.076. View

16.

Alpert M . Obesity cardiomyopathy: pathophysiology and evolution of the clinical syndrome. Am J Med Sci. 2001; 321(4):225-36. DOI: 10.1097/00000441-200104000-00003. View

17.

Ogden C, Yanovski S, Carroll M, Flegal K . The epidemiology of obesity. Gastroenterology. 2007; 132(6):2087-102. DOI: 10.1053/j.gastro.2007.03.052. View

18.

Romero-Corral A, Somers V, Pellikka P, Olson E, Bailey K, Korinek J . Decreased right and left ventricular myocardial performance in obstructive sleep apnea. Chest. 2007; 132(6):1863-70. DOI: 10.1378/chest.07-0966. View

19.

Marfella R, Esposito K, Siniscalchi M, Cacciapuoti F, Giugliano F, Labriola D . Effect of weight loss on cardiac synchronization and proinflammatory cytokines in premenopausal obese women. Diabetes Care. 2003; 27(1):47-52. DOI: 10.2337/diacare.27.1.47. View

20.

Vonk-Noordegraaf A, Marcus J, Holverda S, Roseboom B, Postmus P . Early changes of cardiac structure and function in COPD patients with mild hypoxemia. Chest. 2005; 127(6):1898-903. DOI: 10.1378/chest.127.6.1898. View