title: Is obesity predictive of cardiovascular dysfunction independent of cardiovascular risk factors?
abstract: BACKGROUND
  Obesity is thought to exert detrimental effects on the cardiovascular (CV) system. However, this relationship is impacted by the co-occurrence of CV risk factors, type 2 diabetes (T2DM) and overt disease. We examined the relationships between obesity, assessed by body mass index (BMI) and waist circumference (WC), and CV function in 102 subjects without overt CV disease. We hypothesized that obesity would be independently predictive of CV remodeling and functional differences, especially at peak exercise.
  
  
  METHODS
  Brachial (bSBP) and central (cSBP) systolic pressure, carotid-to-femoral pulse wave velocity (PWVcf) augmentation index (AGI; by SphygmoCor), and carotid remodeling (B-mode ultrasound) were examined at rest. Further, peak exercise cardiac imaging (Doppler ultrasound) was performed to measure the coupling between the heart and arterial system.
  
  
  RESULTS
  In backward elimination regression models, accounting for CV risk factors, neither BMI nor WC were predictors of carotid thickness or PWVcf; rather age, triglycerides and hypertension were the main determinants. However, BMI and WC predicted carotid cross-sectional area and lumen diameter. When examining the relationship between body size and SBP, BMI (β=0.32) and WC (β=0.25) were predictors of bSBP (P<0.05), whereas, BMI was the only predictor of cSBP (β=0.22, P<0.05) indicating a differential relationship between cSBP, bSBP and body size. Further, BMI (β=-0.26) and WC (β=-0.27) were independent predictors of AGI (P<0.05). As for resting cardiac diastolic function, WC seemed to be a better predictor than BMI. However, both BMI and WC were inversely and independently related to arterial-elastance (net arterial load) and end-systolic elastance (cardiac contractility) at rest and peak exercise.
  
  
  CONCLUSIONS
  These findings illustrate that obesity, without T2DM and overt CV disease, and after accounting for CV risk factors, is susceptible to pathophysiological adaptations that may predispose individuals to an increased risk of CV events.
authors: 1] Division of Exercise Physiology, School of Medicine, West Virginia University, Morgantown, WV, USA [2] Center for Cardiovascular and Respiratory Sciences, School of Medicine, West Virginia University, Morgantown, WV, USA.
authors: E
authors: E
authors: DeVallance
authors: 1] Division of Exercise Physiology, School of Medicine, West Virginia University, Morgantown, WV, USA [2] Center for Cardiovascular and Respiratory Sciences, School of Medicine, West Virginia University, Morgantown, WV, USA.
authors: S B
authors: SB
authors: Fournier
authors: Division of Exercise Physiology, School of Medicine, West Virginia University, Morgantown, WV, USA.
authors: D A
authors: DA
authors: Donley
authors: Division of Exercise Physiology, School of Medicine, West Virginia University, Morgantown, WV, USA.
authors: D E
authors: DE
authors: Bonner
authors: Division of Exercise Physiology, School of Medicine, West Virginia University, Morgantown, WV, USA.
authors: K
authors: K
authors: Lee
authors: 1] Center for Cardiovascular and Respiratory Sciences, School of Medicine, West Virginia University, Morgantown, WV, USA [2] Department of Physiology and Pharmacology, School of Medicine, West Virginia University, Morgantown, WV, USA.
authors: J C
authors: JC
authors: Frisbee
authors: 1] Division of Exercise Physiology, School of Medicine, West Virginia University, Morgantown, WV, USA [2] Center for Cardiovascular and Respiratory Sciences, School of Medicine, West Virginia University, Morgantown, WV, USA.
authors: P D
authors: PD
authors: Chantler
mesh_terms: D000328:Adult; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000209:etiology / Q000401:mortality / Q000503:physiopathology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology*; D003925:Diabetic Angiopathies / Q000401:mortality / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000209:etiology / Q000401:mortality / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000401:mortality / Q000503:physiopathology*; D011379:Prognosis; D012307:Risk Factors; D014280:Triglycerides / Q000378:metabolism; D014481:United States / Q000453:epidemiology; D018487:Ventricular Dysfunction, Left / Q000209:etiology / Q000401:mortality / Q000503:physiopathology*
chemical_list: D014280:Triglycerides