title: Association of Weight and Body Composition on Cardiac Structure and Function in the ARIC Study (Atherosclerosis Risk in Communities).
abstract: Obesity increases cardiovascular risk. However, the extent to which various measures of body composition are associated with abnormalities in cardiac structure and function, independent of comorbidities commonly affecting obese individuals, is not clear. This study sought to examine the relationship between body mass index, waist circumference, and percent body fat with conventional and advanced measures of cardiac structure and function.
  
  
  
  We studied 4343 participants of the ARIC study (Atherosclerosis Risk in Communities) who were aged 69 to 82 years, free of coronary heart disease and heart failure, and underwent comprehensive echocardiography. Increasing body mass index, waist circumference, and body fat were associated with greater left ventricular (LV) mass and left atrial volume indexed to height(2.7) in both men and women (P<0.001). In women, all 3 measures were associated with abnormal LV geometry, and increasing waist circumference and body fat were associated with worse global longitudinal strain, a measure of LV systolic function. In both sexes, increasing body mass index was associated with greater right ventricular end-diastolic area and worse right ventricular fractional area change (P≤0.001). We observed similar associations for both waist circumference and percent body fat.
  
  
  
  In a large, biracial cohort of older adults free of clinically overt coronary heart disease or heart failure, obesity was associated with subclinical abnormalities in cardiac structure in both men and women and with adverse LV remodeling and impaired LV systolic function in women. These data highlight the association of obesity and subclinical abnormalities of cardiac structure and function, particularly in women.
authors: From the Division of Cardiology, Department of Medicine, Columbia University Medical Center, New York, NY (N.A.B.); Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (S.C., B.C., A.M.S., G.Q.R., A.B.S.S., S.D.S.); Department of Medicine, Johns Hopkins University, Baltimore, MD (C.E.N., J.C.); Department of Medicine, Vanderbilt Heart and Vascular Institute, Vanderbilt University Medical Center, Nashville, TN (D.G.); Pharmacy Practice Division, University of Wisconsin School of Pharmacy, Madison (O.V.); Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, TX (D.A.); Division of Epidemiology and Community Health, University of Minnesota, Minneapolis (A.R.F.); Department of Medicine, University of Mississippi Medical Center, Jackson (K.R.B.); and Cardiovascular Medicine Section, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC (D.W.K.).
authors: Natalie A
authors: NA
authors: Bello
authors: From the Division of Cardiology, Department of Medicine, Columbia University Medical Center, New York, NY (N.A.B.); Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (S.C., B.C., A.M.S., G.Q.R., A.B.S.S., S.D.S.); Department of Medicine, Johns Hopkins University, Baltimore, MD (C.E.N., J.C.); Department of Medicine, Vanderbilt Heart and Vascular Institute, Vanderbilt University Medical Center, Nashville, TN (D.G.); Pharmacy Practice Division, University of Wisconsin School of Pharmacy, Madison (O.V.); Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, TX (D.A.); Division of Epidemiology and Community Health, University of Minnesota, Minneapolis (A.R.F.); Department of Medicine, University of Mississippi Medical Center, Jackson (K.R.B.); and Cardiovascular Medicine Section, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC (D.W.K.).
authors: Susan
authors: S
authors: Cheng
authors: From the Division of Cardiology, Department of Medicine, Columbia University Medical Center, New York, NY (N.A.B.); Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (S.C., B.C., A.M.S., G.Q.R., A.B.S.S., S.D.S.); Department of Medicine, Johns Hopkins University, Baltimore, MD (C.E.N., J.C.); Department of Medicine, Vanderbilt Heart and Vascular Institute, Vanderbilt University Medical Center, Nashville, TN (D.G.); Pharmacy Practice Division, University of Wisconsin School of Pharmacy, Madison (O.V.); Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, TX (D.A.); Division of Epidemiology and Community Health, University of Minnesota, Minneapolis (A.R.F.); Department of Medicine, University of Mississippi Medical Center, Jackson (K.R.B.); and Cardiovascular Medicine Section, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC (D.W.K.).
authors: Brian
authors: B
authors: Claggett
authors: From the Division of Cardiology, Department of Medicine, Columbia University Medical Center, New York, NY (N.A.B.); Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (S.C., B.C., A.M.S., G.Q.R., A.B.S.S., S.D.S.); Department of Medicine, Johns Hopkins University, Baltimore, MD (C.E.N., J.C.); Department of Medicine, Vanderbilt Heart and Vascular Institute, Vanderbilt University Medical Center, Nashville, TN (D.G.); Pharmacy Practice Division, University of Wisconsin School of Pharmacy, Madison (O.V.); Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, TX (D.A.); Division of Epidemiology and Community Health, University of Minnesota, Minneapolis (A.R.F.); Department of Medicine, University of Mississippi Medical Center, Jackson (K.R.B.); and Cardiovascular Medicine Section, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC (D.W.K.).
authors: Amil M
authors: AM
authors: Shah
authors: From the Division of Cardiology, Department of Medicine, Columbia University Medical Center, New York, NY (N.A.B.); Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (S.C., B.C., A.M.S., G.Q.R., A.B.S.S., S.D.S.); Department of Medicine, Johns Hopkins University, Baltimore, MD (C.E.N., J.C.); Department of Medicine, Vanderbilt Heart and Vascular Institute, Vanderbilt University Medical Center, Nashville, TN (D.G.); Pharmacy Practice Division, University of Wisconsin School of Pharmacy, Madison (O.V.); Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, TX (D.A.); Division of Epidemiology and Community Health, University of Minnesota, Minneapolis (A.R.F.); Department of Medicine, University of Mississippi Medical Center, Jackson (K.R.B.); and Cardiovascular Medicine Section, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC (D.W.K.).
authors: Chiadi E
authors: CE
authors: Ndumele
authors: From the Division of Cardiology, Department of Medicine, Columbia University Medical Center, New York, NY (N.A.B.); Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (S.C., B.C., A.M.S., G.Q.R., A.B.S.S., S.D.S.); Department of Medicine, Johns Hopkins University, Baltimore, MD (C.E.N., J.C.); Department of Medicine, Vanderbilt Heart and Vascular Institute, Vanderbilt University Medical Center, Nashville, TN (D.G.); Pharmacy Practice Division, University of Wisconsin School of Pharmacy, Madison (O.V.); Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, TX (D.A.); Division of Epidemiology and Community Health, University of Minnesota, Minneapolis (A.R.F.); Department of Medicine, University of Mississippi Medical Center, Jackson (K.R.B.); and Cardiovascular Medicine Section, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC (D.W.K.).
authors: Gabriela Querejeta
authors: GQ
authors: Roca
authors: From the Division of Cardiology, Department of Medicine, Columbia University Medical Center, New York, NY (N.A.B.); Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (S.C., B.C., A.M.S., G.Q.R., A.B.S.S., S.D.S.); Department of Medicine, Johns Hopkins University, Baltimore, MD (C.E.N., J.C.); Department of Medicine, Vanderbilt Heart and Vascular Institute, Vanderbilt University Medical Center, Nashville, TN (D.G.); Pharmacy Practice Division, University of Wisconsin School of Pharmacy, Madison (O.V.); Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, TX (D.A.); Division of Epidemiology and Community Health, University of Minnesota, Minneapolis (A.R.F.); Department of Medicine, University of Mississippi Medical Center, Jackson (K.R.B.); and Cardiovascular Medicine Section, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC (D.W.K.).
authors: Angela B S
authors: AB
authors: Santos
authors: From the Division of Cardiology, Department of Medicine, Columbia University Medical Center, New York, NY (N.A.B.); Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (S.C., B.C., A.M.S., G.Q.R., A.B.S.S., S.D.S.); Department of Medicine, Johns Hopkins University, Baltimore, MD (C.E.N., J.C.); Department of Medicine, Vanderbilt Heart and Vascular Institute, Vanderbilt University Medical Center, Nashville, TN (D.G.); Pharmacy Practice Division, University of Wisconsin School of Pharmacy, Madison (O.V.); Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, TX (D.A.); Division of Epidemiology and Community Health, University of Minnesota, Minneapolis (A.R.F.); Department of Medicine, University of Mississippi Medical Center, Jackson (K.R.B.); and Cardiovascular Medicine Section, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC (D.W.K.).
authors: Deepak
authors: D
authors: Gupta
authors: From the Division of Cardiology, Department of Medicine, Columbia University Medical Center, New York, NY (N.A.B.); Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (S.C., B.C., A.M.S., G.Q.R., A.B.S.S., S.D.S.); Department of Medicine, Johns Hopkins University, Baltimore, MD (C.E.N., J.C.); Department of Medicine, Vanderbilt Heart and Vascular Institute, Vanderbilt University Medical Center, Nashville, TN (D.G.); Pharmacy Practice Division, University of Wisconsin School of Pharmacy, Madison (O.V.); Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, TX (D.A.); Division of Epidemiology and Community Health, University of Minnesota, Minneapolis (A.R.F.); Department of Medicine, University of Mississippi Medical Center, Jackson (K.R.B.); and Cardiovascular Medicine Section, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC (D.W.K.).
authors: Orly
authors: O
authors: Vardeny
authors: From the Division of Cardiology, Department of Medicine, Columbia University Medical Center, New York, NY (N.A.B.); Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (S.C., B.C., A.M.S., G.Q.R., A.B.S.S., S.D.S.); Department of Medicine, Johns Hopkins University, Baltimore, MD (C.E.N., J.C.); Department of Medicine, Vanderbilt Heart and Vascular Institute, Vanderbilt University Medical Center, Nashville, TN (D.G.); Pharmacy Practice Division, University of Wisconsin School of Pharmacy, Madison (O.V.); Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, TX (D.A.); Division of Epidemiology and Community Health, University of Minnesota, Minneapolis (A.R.F.); Department of Medicine, University of Mississippi Medical Center, Jackson (K.R.B.); and Cardiovascular Medicine Section, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC (D.W.K.).
authors: David
authors: D
authors: Aguilar
authors: From the Division of Cardiology, Department of Medicine, Columbia University Medical Center, New York, NY (N.A.B.); Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (S.C., B.C., A.M.S., G.Q.R., A.B.S.S., S.D.S.); Department of Medicine, Johns Hopkins University, Baltimore, MD (C.E.N., J.C.); Department of Medicine, Vanderbilt Heart and Vascular Institute, Vanderbilt University Medical Center, Nashville, TN (D.G.); Pharmacy Practice Division, University of Wisconsin School of Pharmacy, Madison (O.V.); Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, TX (D.A.); Division of Epidemiology and Community Health, University of Minnesota, Minneapolis (A.R.F.); Department of Medicine, University of Mississippi Medical Center, Jackson (K.R.B.); and Cardiovascular Medicine Section, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC (D.W.K.).
authors: Aaron R
authors: AR
authors: Folsom
authors: From the Division of Cardiology, Department of Medicine, Columbia University Medical Center, New York, NY (N.A.B.); Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (S.C., B.C., A.M.S., G.Q.R., A.B.S.S., S.D.S.); Department of Medicine, Johns Hopkins University, Baltimore, MD (C.E.N., J.C.); Department of Medicine, Vanderbilt Heart and Vascular Institute, Vanderbilt University Medical Center, Nashville, TN (D.G.); Pharmacy Practice Division, University of Wisconsin School of Pharmacy, Madison (O.V.); Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, TX (D.A.); Division of Epidemiology and Community Health, University of Minnesota, Minneapolis (A.R.F.); Department of Medicine, University of Mississippi Medical Center, Jackson (K.R.B.); and Cardiovascular Medicine Section, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC (D.W.K.).
authors: Kenneth R
authors: KR
authors: Butler
authors: From the Division of Cardiology, Department of Medicine, Columbia University Medical Center, New York, NY (N.A.B.); Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (S.C., B.C., A.M.S., G.Q.R., A.B.S.S., S.D.S.); Department of Medicine, Johns Hopkins University, Baltimore, MD (C.E.N., J.C.); Department of Medicine, Vanderbilt Heart and Vascular Institute, Vanderbilt University Medical Center, Nashville, TN (D.G.); Pharmacy Practice Division, University of Wisconsin School of Pharmacy, Madison (O.V.); Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, TX (D.A.); Division of Epidemiology and Community Health, University of Minnesota, Minneapolis (A.R.F.); Department of Medicine, University of Mississippi Medical Center, Jackson (K.R.B.); and Cardiovascular Medicine Section, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC (D.W.K.).
authors: Dalane W
authors: DW
authors: Kitzman
authors: From the Division of Cardiology, Department of Medicine, Columbia University Medical Center, New York, NY (N.A.B.); Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (S.C., B.C., A.M.S., G.Q.R., A.B.S.S., S.D.S.); Department of Medicine, Johns Hopkins University, Baltimore, MD (C.E.N., J.C.); Department of Medicine, Vanderbilt Heart and Vascular Institute, Vanderbilt University Medical Center, Nashville, TN (D.G.); Pharmacy Practice Division, University of Wisconsin School of Pharmacy, Madison (O.V.); Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, TX (D.A.); Division of Epidemiology and Community Health, University of Minnesota, Minneapolis (A.R.F.); Department of Medicine, University of Mississippi Medical Center, Jackson (K.R.B.); and Cardiovascular Medicine Section, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC (D.W.K.).
authors: Josef
authors: J
authors: Coresh
authors: From the Division of Cardiology, Department of Medicine, Columbia University Medical Center, New York, NY (N.A.B.); Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (S.C., B.C., A.M.S., G.Q.R., A.B.S.S., S.D.S.); Department of Medicine, Johns Hopkins University, Baltimore, MD (C.E.N., J.C.); Department of Medicine, Vanderbilt Heart and Vascular Institute, Vanderbilt University Medical Center, Nashville, TN (D.G.); Pharmacy Practice Division, University of Wisconsin School of Pharmacy, Madison (O.V.); Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, TX (D.A.); Division of Epidemiology and Community Health, University of Minnesota, Minneapolis (A.R.F.); Department of Medicine, University of Mississippi Medical Center, Jackson (K.R.B.); and Cardiovascular Medicine Section, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC (D.W.K.). ssolomon@rics.bwh.harvard.edu.
authors: Scott D
authors: SD
authors: Solomon
mesh_terms: D050154:Adiposity / Q000208:ethnology; D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D050197:Atherosclerosis / Q000175:diagnosis / Q000208:ethnology / Q000503:physiopathology*; D015992:Body Mass Index; D001835:Body Weight / Q000208:ethnology; D003430:Cross-Sectional Studies; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000208:ethnology / Q000503:physiopathology*; D008297:Male; D009765:Obesity / Q000175:diagnosis / Q000208:ethnology / Q000503:physiopathology*; D011446:Prospective Studies; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000208:ethnology / Q000503:physiopathology*; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging / Q000208:ethnology / Q000503:physiopathology*; D016277:Ventricular Function, Left; D016278:Ventricular Function, Right; D020257:Ventricular Remodeling; D055105:Waist Circumference; D044465:White People
keywords: atherosclerosis; body mass index; echocardiography; obesity; ventricular remodeling