title: Relationship between body composition and left ventricular geometry using three dimensional cardiovascular magnetic resonance.
abstract: Although obesity is associated with alterations in left ventricular (LV) mass and volume which are of prognostic significance, widely differing patterns of remodelling have been attributed to adiposity. Our aim was to define the relationship between body composition and LV geometry using three-dimensional cardiovascular magnetic resonance.
  
  
  
  In an observational study 1530 volunteers (55 % female, mean age 41.3 years) without known cardiovascular disease underwent investigation including breath-hold high spatial resolution 3D cines. Atlas-based segmentation and co-registration was used to create a statistical model of wall thickness (WT) and relative wall thickness (RWT) throughout the LV. The relationship between bio-impedence body composition and LV geometry was assessed using 3D regression models adjusted for age, systolic blood pressure (BP), gender, race and height, with correction to control the false discovery rate.
  
  
  
  LV mass was positively associated with fat mass in women but not in men (LV mass: women β = 0.11, p < 0.0001; men β = -0.01, p = 0.82). The 3D models revealed that in males fat mass was strongly associated with a concentric increase in relative wall thickness (RWT) throughout most of the LV (β = 0.37, significant area = 96 %) and a reduced mid-ventricular cavity (β = -0.22, significant area = 91 %). In women the regional concentric hypertrophic association was weaker, and the basal lateral wall showed an inverse relationship between RWT and fat mass (β = -0.11, significant area = 4.8 %).
  
  
  
  In an adult population without known cardiovascular disease increasing body fat is predominately associated with asymmetric concentric hypertrophy independent of systolic BP, with women demonstrating greater cavity dilatation than men. Conventional mass and volume measurements underestimate the impact of body composition on LV structure due to anatomic variation in remodelling.
authors.affiliation: Medical Research Council Clinical Sciences Centre, Faculty of Medicine, Imperial College London, Hammersmith Hospital Campus, London, UK.
authors.forename: Ben
authors.initials: B
authors.lastname: Corden
authors.affiliation: Medical Research Council Clinical Sciences Centre, Faculty of Medicine, Imperial College London, Hammersmith Hospital Campus, London, UK.
authors.forename: Antonio
authors.initials: A
authors.lastname: de Marvao
authors.affiliation: Medical Research Council Clinical Sciences Centre, Faculty of Medicine, Imperial College London, Hammersmith Hospital Campus, London, UK.
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Dawes
authors.affiliation: Medical Research Council Clinical Sciences Centre, Faculty of Medicine, Imperial College London, Hammersmith Hospital Campus, London, UK.|Department of Computing, Imperial College London, South Kensington Campus, London, UK.
authors.forename: Wenzhe
authors.initials: W
authors.lastname: Shi
authors.affiliation: Department of Computing, Imperial College London, South Kensington Campus, London, UK.
authors.forename: Daniel
authors.initials: D
authors.lastname: Rueckert
authors.affiliation: Medical Research Council Clinical Sciences Centre, Faculty of Medicine, Imperial College London, Hammersmith Hospital Campus, London, UK.|National Heart Centre Singapore, Singapore and Duke-NUS Graduate Medical School, Singapore, Singapore.
authors.forename: Stuart A
authors.initials: SA
authors.lastname: Cook
authors.affiliation: Medical Research Council Clinical Sciences Centre, Faculty of Medicine, Imperial College London, Hammersmith Hospital Campus, London, UK. declan.oregan@imperial.ac.uk.
authors.forename: Declan P
authors.initials: DP
authors.lastname: O'Regan
mesh_terms: D050154:Adiposity; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D062485:Breath Holding; D003430:Cross-Sectional Studies; D017097:Electric Impedance; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods*; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012737:Sex Factors; D016277:Ventricular Function, Left; D020257:Ventricular Remodeling; D055815:Young Adult
keywords: Body composition; Cardiac atlas; Cardiac remodelling; Cardiovascular magnetic resonance; Obesity