title: Contribution of central adiposity to left ventricular diastolic function (from the Baltimore Longitudinal Study of Aging).
abstract: We examined the relations of central adiposity with left ventricular (LV) diastolic dysfunction in men and women who participated in the Baltimore Longitudinal Study of Aging, a prospective community-based study of older persons. The sample for this cross-sectional analysis included 399 women and 370 men. Central adiposity was estimated using the waist circumference (WC) and global adiposity using the body mass index (BMI). Using data from a comprehensive echocardiographic study that included tissue Doppler imaging, diastolic function was graded according to 3 parameters (E/A ratio, E/Em ratio, and left atrial volume index). In the logistic regression models adjusted for age, gender, cardiovascular risk factors, and hemodynamic parameters, WC and BMI were both independently associated with LV diastolic dysfunction. However, when both WC and BMI were in the same model, only WC remained significantly associated with LV diastolic dysfunction (odds ratio 1.04, 95% confidence interval 1.01 to 1.08, p = 0.02). In the gender-stratified analyses, WC was significantly associated with LV diastolic dysfunction-independently of BMI-in women (odds ratio 1.08, 95% confidence interval 1.04 to 1.14, p <0.001) but not in men (odds ratio 1.00, 95% confidence interval 0.95 to 1.05, p = 0.91). Additional adjustment for LV mass index failed to modify these relations. In conclusion, the adverse effect of central adiposity on LV diastolic function was independent of general adiposity and more pronounced among women. The effect of visceral adiposity on LV diastolic dysfunction would benefit from confirmation in longitudinal studies.
authors.affiliation: Longitudinal Studies Section, Clinical Research Branch, National Institute on Aging, National Institutes of Health, Baltimore, Maryland, USA. marco.canepa@nih.gov
authors.forename: Marco
authors.initials: M
authors.lastname: Canepa
authors.forename: James B
authors.initials: JB
authors.lastname: Strait
authors.forename: Dmitry
authors.initials: D
authors.lastname: Abramov
authors.forename: Yuri
authors.initials: Y
authors.lastname: Milaneschi
authors.forename: Majd
authors.initials: M
authors.lastname: AlGhatrif
authors.forename: Monika
authors.initials: M
authors.lastname: Moni
authors.forename: Ramona
authors.initials: R
authors.lastname: Ramachandran
authors.forename: Samer S
authors.initials: SS
authors.lastname: Najjar
authors.forename: Claudio
authors.initials: C
authors.lastname: Brunelli
authors.forename: Theodore P
authors.initials: TP
authors.lastname: Abraham
authors.forename: Edward G
authors.initials: EG
authors.lastname: Lakatta
authors.forename: Luigi
authors.initials: L
authors.lastname: Ferrucci
mesh_terms: D000368:Aged; D015142:Baltimore; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D003971:Diastole / Q000502:physiology*; D004452:Echocardiography; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D056128:Obesity, Abdominal / Q000503:physiopathology*; D011446:Prospective Studies; D012737:Sex Factors; D018608:Ultrasonography, Doppler; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology*; D055105:Waist Circumference / Q000502:physiology