title: Visceral adiposity and left ventricular mass and function in patients with aortic stenosis: the PROGRESSA study.
abstract: BACKGROUND
  Recent studies have reported that obesity, metabolic syndrome, and diabetes are associated with left ventricular (LV) hypertrophy (LVH) and dysfunction in patients with aortic stenosis (AS). The purpose of this study was to examine the association between amount and distribution of body fat and LVH and systolic dysfunction in AS patients.
  
  
  METHODS
  One hundred twenty-four patients with AS were prospectively recruited in the PROGRESSA (Metabolic Determinants of the Progression of Aortic Stenosis) study and underwent Doppler echocardiography and computed tomography scan. Presence and severity of LVH was assessed according to LV mass indexed for height(2.7) and LV dysfunction according to global longitudinal strain (GLS). Computed tomography was used to quantify abdominal visceral (VAT) and subcutaneous (SAT) adipose tissue, and total adipose tissue (TAT).
  
  
  RESULTS
  Body mass index (BMI) correlated strongly with TAT (r = 0.85), moderately with VAT (r = 0.70), and SAT (r = 0.69), and weakly with the proportion of VAT (VAT/TAT ratio: r = 0.19). In univariate analysis, greater BMI, TAT, VAT, SAT, and VAT/TAT were associated with increased LV mass index and greater VAT and VAT/TAT ratio were associated with reduced GLS. Multivariate analysis revealed that larger BMI (P < 0.0001) and greater VAT/TAT ratio (P = 0.01) were independently associated with higher prevalence of LVH, and only the VAT/TAT ratio (P = 0.03) was independently associated with reduced GLS.
  
  
  CONCLUSIONS
  The results of this study suggest that total and visceral adiposity are independently associated with LVH in patients with AS. Furthermore, impairment of LV systolic function does not appear to be influenced by total obesity but is rather related to excess visceral adiposity. These findings provide impetus for elaboration of interventional studies aiming at visceral adiposity in the AS population.
authors: Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart and Lung Institute, Laval University, Québec City, Québec, Canada.
authors: Romain
authors: R
authors: Capoulade
authors: Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart and Lung Institute, Laval University, Québec City, Québec, Canada.
authors: Eric
authors: E
authors: Larose
authors: Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart and Lung Institute, Laval University, Québec City, Québec, Canada.
authors: Patrick
authors: P
authors: Mathieu
authors: Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart and Lung Institute, Laval University, Québec City, Québec, Canada.
authors: Marie-Annick
authors: MA
authors: Clavel
authors: Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart and Lung Institute, Laval University, Québec City, Québec, Canada.
authors: Abdellaziz
authors: A
authors: Dahou
authors: Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart and Lung Institute, Laval University, Québec City, Québec, Canada.
authors: Marie
authors: M
authors: Arsenault
authors: Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart and Lung Institute, Laval University, Québec City, Québec, Canada.
authors: Elisabeth
authors: E
authors: Bédard
authors: Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart and Lung Institute, Laval University, Québec City, Québec, Canada.
authors: Samuel
authors: S
authors: Larue-Grondin
authors: Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart and Lung Institute, Laval University, Québec City, Québec, Canada.
authors: Florent
authors: F
authors: Le Ven
authors: Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart and Lung Institute, Laval University, Québec City, Québec, Canada.
authors: Jean G
authors: JG
authors: Dumesnil
authors: Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart and Lung Institute, Laval University, Québec City, Québec, Canada.
authors: Jean-Pierre
authors: JP
authors: Després
authors: Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart and Lung Institute, Laval University, Québec City, Québec, Canada. Electronic address: philippe.pibarot@med.ulaval.ca.
authors: Philippe
authors: P
authors: Pibarot
mesh_terms: D000273:Adipose Tissue / Q000033:anatomy & histology*; D000368:Aged; D001024:Aortic Valve Stenosis / Q000473:pathology* / Q000503:physiopathology*; D015992:Body Mass Index; D015150:Echocardiography, Doppler; D005260:Female; D006352:Heart Ventricles / Q000033:anatomy & histology* / Q000503:physiopathology; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D011446:Prospective Studies; D050151:Subcutaneous Fat / Q000033:anatomy & histology; D014057:Tomography, X-Ray Computed; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology*; D014781:Viscera / Q000033:anatomy & histology*