title: Left Ventricular Function Across the Spectrum of Body Mass Index in African Americans: The Jackson Heart Study.
abstract: This study sought to assess whether body mass index (BMI) was associated with subclinical left ventricular (LV) systolic dysfunction in African-American individuals.
  
  
  
  Higher BMI is a risk factor for cardiovascular disease, including heart failure. Obesity disproportionately affects African Americans; however, the association between higher BMI and LV function in African Americans is not well understood.
  
  
  
  Peak systolic circumferential strain (ECC) was measured by tagged cardiac magnetic resonance in 1,652 adult African-American participants of the Jackson Heart Study between 2008 and 2012. We evaluated the association between BMI and ECC in multivariate linear regression and restricted cubic spline analyses adjusted for prevalent cardiovascular disease, conventional cardiovascular risk factors, LV mass, and ejection fraction. In exploratory analyses, we also examined whether inflammation, insulin resistance, or volume of visceral adipose tissue altered the association between BMI and ECC.
  
  
  
  The proportions of female, nonsmokers, diabetic, and hypertensive participants rose with increase in BMI. In multivariate-adjusted models, higher BMI was associated with worse ECC (β = 0.052; 95% confidence interval: 0.028 to 0.075), even in the setting of preserved LV ejection fraction. Higher BMI was also associated with worse ECC when accounting for markers of inflammation (C-reactive protein, E-selection, and P-selectin), insulin resistance, and volume of visceral adipose tissue.
  
  
  
  Higher BMI is significantly associated with subclinical LV dysfunction in African Americans, even in the setting of preserved LV ejection fraction.
authors.affiliation: Vanderbilt University School of Medicine, Nashville, Tennessee; Vanderbilt Translational and Clinical Cardiovascular Research Center, Nashville, Tennessee. Electronic address: vivek.patel@vanderbilt.edu.
authors.forename: Vivek G
authors.initials: VG
authors.lastname: Patel
authors.affiliation: Vanderbilt University School of Medicine, Nashville, Tennessee; Vanderbilt Translational and Clinical Cardiovascular Research Center, Nashville, Tennessee.
authors.forename: Deepak K
authors.initials: DK
authors.lastname: Gupta
authors.affiliation: Vanderbilt University School of Medicine, Nashville, Tennessee; Vanderbilt Translational and Clinical Cardiovascular Research Center, Nashville, Tennessee.
authors.forename: James G
authors.initials: JG
authors.lastname: Terry
authors.affiliation: Vanderbilt University School of Medicine, Nashville, Tennessee; Vanderbilt Translational and Clinical Cardiovascular Research Center, Nashville, Tennessee; Jackson Heart Study Vanguard Center at Vanderbilt University, Nashville, Tennessee.
authors.forename: Edmond K
authors.initials: EK
authors.lastname: Kabagambe
authors.affiliation: Vanderbilt University School of Medicine, Nashville, Tennessee; Vanderbilt Translational and Clinical Cardiovascular Research Center, Nashville, Tennessee.
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Wang
authors.affiliation: University of Mississippi Medical Center, Jackson, Mississippi.
authors.forename: Aldolfo
authors.initials: A
authors.lastname: Correa
authors.affiliation: University of Mississippi Medical Center, Jackson, Mississippi.
authors.forename: Michael
authors.initials: M
authors.lastname: Griswold
authors.affiliation: University of Mississippi Medical Center, Jackson, Mississippi; Morehouse School of Medicine, Atlanta, Georgia.
authors.forename: Herman
authors.initials: H
authors.lastname: Taylor
authors.affiliation: Vanderbilt University School of Medicine, Nashville, Tennessee; Vanderbilt Translational and Clinical Cardiovascular Research Center, Nashville, Tennessee.
authors.forename: John Jeffrey
authors.initials: JJ
authors.lastname: Carr
mesh_terms: D001741:Black or African American; D000368:Aged; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000276:immunology; D015331:Cohort Studies; D019040:E-Selectin / Q000276:immunology; D005260:Female; D006801:Humans; D007249:Inflammation; D007333:Insulin Resistance; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging; D016014:Linear Models; D008279:Magnetic Resonance Imaging; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D015999:Multivariate Analysis; D009765:Obesity / Q000453:epidemiology* / Q000276:immunology / Q000378:metabolism; D050177:Overweight / Q000453:epidemiology / Q000276:immunology / Q000378:metabolism; D019007:P-Selectin / Q000276:immunology; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000276:immunology / Q000378:metabolism; D016277:Ventricular Function, Left
chemical_list: D019040:E-Selectin; D019007:P-Selectin; C546936:SELE protein, human; C546937:SELP protein, human; D002097:C-Reactive Protein
keywords: BMI; Jackson Heart Study; LV function; cardiovascular disease; heart failure