title: Weight loss and progressive left ventricular remodelling: The Multi-Ethnic Study of Atherosclerosis (MESA).
abstract: OBJECTIVE
  Impact of weight loss on cardiac structure has not been extensively investigated in large, multi-ethnic, community-based populations. We investigated the longitudinal impact of weight loss on cardiac structure by cardiac magnetic resonance (CMR).
  
  
  RESULTS
  2351 participants in the Multi-Ethnic Study of Atherosclerosis (MESA) who underwent CMR at Exam 1 (2002) and Exam 5 (2011) were included. Primary outcomes were percentage change in LV mass (indexed to height) and LV mass-to-volume ratio (concentric LV remodelling). Multivariable linear regression was used to measure the association between outcomes and weight change. At median 9.4 years' follow-up, 639 individuals (27%) experienced >5% weight loss (median 6.9 kg) and 511 (22%) had >5% weight gain (median 6.4 kg). A >5% weight gain was associated with the greatest increase in LV mass (+5.4% median) and LV mass-to-volume ratio (+12.2% median). Adjusting for medications, hypertension/diabetes (and change in these risk factors), age, race and other risk factors, every 5% weight loss was associated with a 1.3% decrease in height-indexed LV mass and 1.3% decrease in LV mass-to-volume ratio (p<0.0001). There was no effect modification/confounding by age, race, gender or baseline BMI. Change in LV mass-to-volume ratio was roughly linear, specifically for modest degrees of weight loss (-10% to +10%). Change in LV mass was linear with weight loss, suggesting no threshold of weight loss is needed for LV mass regression.
  
  
  CONCLUSIONS
  In a large multi-ethnic population, weight loss is associated with beneficial effects on cardiac structure, independent of age, race, gender, BMI and obesity-related cardiometabolic risk. There is no threshold of weight loss required to produce these effects.
authors.affiliation: Cardiology Division, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Ravi V
authors.initials: RV
authors.lastname: Shah
authors.affiliation: Department of Medicine (Cardiovascular Medicine Division) and Department of Radiology (Nuclear Medicine and Cardiothoracic Imaging Divisions), University of Michigan, Ann Arbor, MI, USA.
authors.forename: Venkatesh L
authors.initials: VL
authors.lastname: Murthy
authors.affiliation: Non-Invasive Cardiovascular Imaging, Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: Siddique A
authors.initials: SA
authors.lastname: Abbasi
authors.affiliation: Office of Biostatistics Research, National Heart, Lung, and Blood Institute, Bethesda, MD, USA.
authors.forename: John
authors.initials: J
authors.lastname: Eng
authors.affiliation: Office of Biostatistics Research, National Heart, Lung, and Blood Institute, Bethesda, MD, USA.
authors.forename: Colin
authors.initials: C
authors.lastname: Wu
authors.affiliation: Cardiology Division, Johns Hopkins Bayview Medical Center, Baltimore, MD, USA.
authors.forename: Pamela
authors.initials: P
authors.lastname: Ouyang
authors.affiliation: Non-Invasive Cardiovascular Imaging, Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: Raymond Y
authors.initials: RY
authors.lastname: Kwong
authors.affiliation: Joslin Diabetes Center, Boston, MA, USA.
authors.forename: Allison
authors.initials: A
authors.lastname: Goldfine
authors.affiliation: Radiology and Imaging Sciences, National Institutes of Health Clinical Center, National Institute of Biomedical Imaging and Bioengineering, Bethesda, MD, USA.
authors.forename: David A
authors.initials: DA
authors.lastname: Bluemke
authors.affiliation: Department of Cardiology and Medicine, Johns Hopkins Medical Center, Baltimore, MD, USA.
authors.forename: Joao
authors.initials: J
authors.lastname: Lima
authors.affiliation: Non-Invasive Cardiovascular Imaging, Brigham and Women's Hospital, Boston, MA, USA mjerosch-herold@partners.org.
authors.forename: Michael
authors.initials: M
authors.lastname: Jerosch-Herold
mesh_terms: D000368:Aged; D050197:Atherosclerosis / Q000175:diagnosis / Q000208:ethnology; D005260:Female; D006304:Health Status; D006333:Heart Failure / Q000175:diagnosis / Q000208:ethnology / Q000503:physiopathology*; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis / Q000208:ethnology / Q000503:physiopathology*; D016014:Linear Models; D008137:Longitudinal Studies; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000175:diagnosis / Q000208:ethnology / Q000503:physiopathology*; D011379:Prognosis; D011446:Prospective Studies; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D016277:Ventricular Function, Left; D020257:Ventricular Remodeling; D015431:Weight Loss / Q000208:ethnology
keywords: Obesity; cardiac magnetic resonance; weight loss