Influence of abdominal circumference on the inappropriateness of left ventricular mass and diastolic function in non-obese patients.
OBJECTIVE
Adipose tissue may be one of the sources of the humoral factors increasing left ventricular mass (LVM) via non-hemodynamic mechanisms. The involvement of visceral obesity in excessive or inappropriate LVM has not been established. We investigated the effect of abdominal circumference on the inappropriateness of LVM in non-obese patients.


METHODS
Echocardiographic parameters for LVM and the indices for diastolic function were analyzed in 312 non-obese patients. Inappropriate LVM was defined as observed/predicted ratio (OPR) of LVM > 130%. Predicted LVM was calculated by the equation of 54.9 + 7.62 x height (m(2.7)) + 0.67 x stroke work--13.2 x sex (male = 1, female = 2). Abdominal obesity was defined by abdominal circumference > 80 cm in females and > 90 cm in males.


RESULTS
Multiple regression analysis showed abdominal circumference was a significant factor for OPR of LVM (beta = 0.256) which was independent of age (beta = 0.215), sex, systolic blood pressure (beta = -0.232), body mass index (beta = 0.232), and fasting blood glucose (beta = 0.146). Odds ratio (OR) of abdominal obesity for inappropriate LVM was 3.28 (1.72-6.28), which was independent of age > or = 55 [OR: 2.17(1.11-4.25)], body mass index > or = 22.5 kg/m2 [OR: 2.24(1.13-4.41)], and diabetes mellitus [OR: 2.27 (1.06-4.85)]. Age and sex adjusted abdominal circumference (86.4 +/- 0.9 vs 82.1 +/- 0.5), abdominal obesity (28.1% vs 54.1%), and metabolic syndrome (19.4% vs 51.6%) were higher in the inappropriate LVM group than the appropriate LVM group (p < 0.001).


CONCLUSIONS
Abdominal obesity or the presence of metabolic syndrome is an important factor to predict the inappropriateness of LVM even in non-obese patients.
Shin
Jinho
J
Cardiology Division, Department of Internal Medicine, Hanyang University Medical Center, #17 Hangdang-dong Sungdong-Ku, Seoul, Korea 133-792.
Lee
Jae Ung
JU
Kim
Kyung Soo
KS
Kim
Soon Gil
SG
Kim
Jeong Hyun
JH
Lim
Heon Kil
HK
Lee
Bang Hun
BH
D000005:Abdomen; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D003971:Diastole / Q000502:physiology*; D004452:Echocardiography; D005260:Female; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008297:Male; D024821:Metabolic Syndrome / Q000503:physiopathology*; D008875:Middle Aged; D009765:Obesity / Q000503:physiopathology; D012044:Regression Analysis