title: Visceral adiposity and left ventricular remodeling: The Multi-Ethnic Study of Atherosclerosis.
abstract: OBJECTIVE
  Visceral fat (VF) is a source of pro-inflammatory adipokines implicated in cardiac remodeling. We sought to determine the impact of visceral fat and subcutaneous fat (SQ) depots on left ventricular (LV) structure, function, and geometry in the Multi-Ethnic Study of Atherosclerosis (MESA).
  
  
  RESULTS
  We performed a post-hoc analysis on 1151 participants from MESA with cardiac magnetic resonance quantification of LV mass and LV mass-to-volume ratio (LVMV, an index of concentricity) and computed tomographic-derived SQ and VF area. Multivariable regression models to estimate association between height-indexed SQ and VF area (per cm(2)/m) with height-indexed LV mass (per height(2.7)) and LVMV were constructed, adjusted for clinical, biochemical, and demographic covariates. We found that both VF and SQ area were associated with height-indexed LV mass (ρ = 0.36 and 0.12, P < 0.0001, respectively), while only VF area was associated with LVMV (ρ = 0.28, P < 0.0001). Individuals with above-median VF had lower LV ejection fraction, greater indexed LV volumes and mass, and higher LVMV (all P < 0.001). In multivariable models adjusted for weight, VF (but not SQ) area was associated with LV concentricity and LV mass index, across both sexes.
  
  
  CONCLUSIONS
  Visceral adiposity is independently associated with LV concentricity, a precursor to heart failure. Further study into the role of VF in LV remodeling as a potential therapeutic target is warranted.
authors.affiliation: Department of Medicine (Cardiology Division), Warren Alpert Medical School of Brown University, United States.
authors.forename: S A
authors.initials: SA
authors.lastname: Abbasi
authors.affiliation: Department of Internal Medicine/Cardiology, Wake Forest University Health Sciences, Winston-Salem, NC, United States.
authors.forename: W G
authors.initials: WG
authors.lastname: Hundley
authors.affiliation: National Institutes of Health Clinical Center, National Institute of Biomedical Imaging and Bioengineering, Bethesda, MD, United States.
authors.forename: D A
authors.initials: DA
authors.lastname: Bluemke
authors.affiliation: Department of Radiology, Brigham and Women's Hospital, Boston, MA, United States.
authors.forename: M
authors.initials: M
authors.lastname: Jerosch-Herold
authors.affiliation: Noninvasive Cardiovascular Imaging Program, Department of Medicine (Cardiovascular Division) and Department of Radiology, Brigham and Women's Hospital, Boston, MA, United States.
authors.forename: R
authors.initials: R
authors.lastname: Blankstein
authors.affiliation: William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, London, UK.
authors.forename: Steffen E
authors.initials: SE
authors.lastname: Petersen
authors.affiliation: Department of Cardiovascular Medicine, University of Oxford, Oxford, UK.
authors.forename: Oliver J
authors.initials: OJ
authors.lastname: Rider
authors.affiliation: Division of Cardiology, Heart and Vascular Institute, Johns Hopkins School of Medicine, Baltimore, MD, Unites Sates.
authors.forename: J A C
authors.initials: JA
authors.lastname: Lima
authors.affiliation: Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, CA, United States.
authors.forename: M A
authors.initials: MA
authors.lastname: Allison
authors.affiliation: Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, Unites states; Division of Nuclear Medicine, Department of Radiology, University of Michigan, Ann Arbor, MI, United States. Electronic address: vlmurthy@med.umich.edu.
authors.forename: V L
authors.initials: VL
authors.lastname: Murthy
authors.affiliation: Department of Medicine, Cardiovascular Division, Beth Israel Deaconess Medical Center, Boston, MA, United States. Electronic address: rshah1@bidmc.harvard.edu.
authors.forename: R V
authors.initials: RV
authors.lastname: Shah
mesh_terms: D054392:Adipokines / Q000378:metabolism; D000368:Aged; D050197:Atherosclerosis / Q000473:pathology*; D015992:Body Mass Index; D005006:Ethnicity; D005260:Female; D006352:Heart Ventricles / Q000473:pathology; D006801:Humans; D050152:Intra-Abdominal Fat / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D056128:Obesity, Abdominal / Q000208:ethnology*; D013318:Stroke Volume; D050151:Subcutaneous Fat / Q000473:pathology; D014057:Tomography, X-Ray Computed; D014481:United States; D020257:Ventricular Remodeling
chemical_list: D054392:Adipokines
keywords: Cardiac magnetic resonance imaging; Obesity; Remodeling; Visceral adiposity