title: Obesity and right ventricular structure and function: the MESA-Right Ventricle Study.
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.
authors.affiliation: Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD.
authors.forename: Harjit
authors.initials: H
authors.lastname: Chahal
authors.affiliation: Department of Biostatistics, University of Washington, Seattle, WA.
authors.forename: Robyn L
authors.initials: RL
authors.lastname: McClelland
authors.affiliation: Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
authors.forename: Harikrishna
authors.initials: H
authors.lastname: Tandri
authors.affiliation: Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD.
authors.forename: Aditya
authors.initials: A
authors.lastname: Jain
authors.affiliation: Department of Radiology and Imaging Sciences, National Institutes of Health/Clinical Center, National Institute of Biomedical Imaging and Bioengineering, Bethesda, MD.
authors.forename: Evrim B
authors.initials: EB
authors.lastname: Turkbey
authors.affiliation: Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC.
authors.forename: W Gregory
authors.initials: WG
authors.lastname: Hundley
authors.affiliation: Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY.
authors.forename: R Graham
authors.initials: RG
authors.lastname: Barr
authors.affiliation: Department of Medicine, Weill Cornell Medical College, New York, NY.
authors.forename: Jorge
authors.initials: J
authors.lastname: Kizer
authors.affiliation: Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
authors.forename: João A C
authors.initials: JAC
authors.lastname: Lima
authors.affiliation: Department of Radiology and Imaging Sciences, National Institutes of Health/Clinical Center, National Institute of Biomedical Imaging and Bioengineering, Bethesda, MD.
authors.forename: David A
authors.initials: DA
authors.lastname: Bluemke
authors.affiliation: Penn Cardiovascular Institute, Department of Medicine, and Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Electronic address: kawut@upenn.edu.
authors.forename: Steven M
authors.initials: SM
authors.lastname: Kawut
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D005260:Female; D006352:Heart Ventricles / Q000503:physiopathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000208:ethnology / Q000503:physiopathology*; D011446:Prospective Studies