Body Composition and Prevalence of Left Ventricular Hypertrophy

Kuch, Bernhard; Hense, Hans‐Werner; Gneiting, Birgit; Döring, Angela; Muscholl, M.; Bröckel, Ulrich; Schunkert, Heribert

doi:10.1161/01.cir.102.4.405

Cited by 92 publications

(70 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Only 1 obese woman had LV hypertrophy on the basis of her LV mass/FFM index. 22 However, obese women had evidence of concentric remodeling based on their increased RWT (PϽ0.005). 25 Figure 1A) and RWT (rϭ0.51, PϽ0.005).…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Effect of Obesity and Insulin Resistance on Myocardial Substrate Metabolism and Efficiency in Young Women

et al. 2004

View full text Add to dashboard Cite

Background-Obesity is a risk factor for impaired cardiac performance, particularly in women. Animal studies suggest that alterations in myocardial fatty acid metabolism and efficiency in obesity can cause decreased cardiac performance.In the present study, we tested the hypothesis that myocardial fatty acid metabolism and efficiency are abnormal in obese women. (rϭ0.58, PϽ0.005). A multivariate, stepwise regression analysis showed that BMI was the only independent predictor of MV O 2 and efficiency (Pϭ0.0005 and PϽ0.05, respectively). Glucose AUC was the only independent predictor of MFAUp, MFAU, and MFAO (PϽ0.05, Ͻ0.005, and Ͻ0.005, respectively). Conclusions-In young women, obesity is a significant predictor of increased MV O 2 and decreased efficiency, and insulin resistance is a robust predictor of MFAUp, MFAU, and MFAO. This increase in fatty acid metabolism and decrease in efficiency is concordant with observations made in experimental models of obesity. These metabolic changes may play a role in the pathogenesis of decreased cardiac performance in obese women.

show abstract

Section: Resultsmentioning

confidence: 99%

“…21 LV mass was also expressed relative to FFM in the obese subjects; over 4.1 g/kg FFM was considered to be LV hypertrophy. 22 Relative wall thickness (RWT) was calculated as (2ϫposterior wall thickness at end diastole)/LV diastolic dimension. LV ejection fraction (EF) was calculated by the modified Simpson method.…”

Section: Echocardiographymentioning

confidence: 99%

Effect of Obesity and Insulin Resistance on Myocardial Substrate Metabolism and Efficiency in Young Women

et al. 2004

View full text Add to dashboard Cite

show abstract

“…In our multivariate model, we could show that fat mass in women but not in men mostly and even more effectively than the presence of CVD explained the variability in left ventricular mass. When BMI was substituted for FFM and fat mass in the multivariate model, the results were nearly the same, suggesting that the overall excess body fat (FFM is also increased in obese subjects [18]) in diabetic and pre-diabetic women is responsible for the increased risk of left ventricular hypertrophy. Of interest, the risk of concentric left ventricular hypertrophy in particular increased with higher BMI in women, although obesity, because of its induced volume overload, is commonly thought to be associated with eccentric hypertrophy (6,7).…”

Section: Left Ventricular Mass In Diabetesmentioning

confidence: 89%

“…Three weight groups, normal weight, overweight, and obesity, were defined as BMI Ͻ25, 25-29.9, and Ն30 kg/ m 2 , respectively (16). Fat-free mass (FFM) was determined by measuring bioelectrical impedance as reported in detail previously (17,18). Body fat mass was calculated after subtraction of FFM from total body weight in kilograms.…”

Section: Research Design Andmentioning

confidence: 99%

Sex-Specific Determinants of Left Ventricular Mass in Pre-Diabetic and Type 2 Diabetic Subjects

et al. 2007

Self Cite

View full text Add to dashboard Cite

OBJECTIVE -Obesity and hypertension are regarded as the most important determinants of left ventricular mass in the community. Little is known about sex-specific influences of obesity, hypertension, and other risk factors on left ventricular mass in pre-diabetic or diabetic subjects.RESEARCH DESIGN AND METHODS -We examined how body composition, blood pressure, and other factors are related to left ventricular structure in elderly subjects (mean age 62 years, 88% of women postmenopausal) with pre-diabetes (impaired fasting glucose or impaired glucose tolerance; n ϭ 112) and diabetes with (n ϭ 181) and without (n ϭ 213) overt cardiovascular disease (CVD).RESULTS -Neither microalbuminuria nor physical activity was significantly associated with left ventricular mass. In pre-diabetic as well as diabetic subjects with CVD, mainly BMI and fat mass, particularly in women, were correlated with left ventricular mass. In the diabetic group without overt CVD, fat mass was only slightly correlated with left ventricular mass. In the latter group waist-to-hip-ratio, and, only in men, systolic blood pressure, glucose, and A1C were moderately correlated with left ventricular mass. Multiregression analysis over all groups again revealed fat mass as the main determinant of left ventricular mass in women. In women but not men obesity was associated with a significantly increased prevalence of concentric left ventricular hypertrophy.CONCLUSIONS -In pre-diabetic and diabetic elderly subjects fat mass is the major determinant of left ventricular mass in women but not in men. These results may partly explain sex differences in CVD mortality in obese elderly diabetic subjects and underscore the need for activities focused on weight reduction. Diabetes Care 30:946 -952, 2007L eft ventricular hypertrophy is independently associated with congestive heart failure and cardiovascular mortality (1-3). Diabetes is also known as an important risk factor for cardiovascular morbidity and mortality, and this association is partly mediated by its effect on left ventricular structure. Traditionally, hypertension and obesity have been regarded as the most important etiological factors in the development of left ventricular hypertrophy in the community (4 -8). Diabetes and impaired glucose tolerance (IGT) or impaired fasting glucose (IFG), the latter being regarded as a preclinical stage of diabetes, are also recognized as independent risk factors for the development of left ventricular hypertrophy (9 -11). However, the role of the traditional etiological risk factors in prediabetic or diabetic subjects is unknown. In patients with more advanced stages of diabetes, in particular, it has been speculated that the traditional risk factors for left ventricular hypertrophy may have a lesser influence on left ventricular mass because of other mechanisms that may become more important (12). Furthermore, although it is known that in the general population cardiac adaptations to obesity and hypertension are sex-specific (7,8) and, in addition, influences of di...

show abstract

“…The reason for the incomplete age normalization might be given by the fact that the inadequate normalization achieved by indexing to height to the power of 2.7 in very small individuals was apparently ignored in the original publication, which encompassed 241 adults and 444 infants, children, and adolescents (11). LVM is likely to scale best to lean body mass (17,18), of which height, even if used with allometric correction factors, is a rather imperfect surrogate. Whereas a precise assessment of lean body mass requires elaborate technologies such as densitometry or isotope dilution studies, allometric equations utilizing height and weight allow for estimation of lean body mass.…”

Section: Discussionmentioning

confidence: 99%

Defining Left Ventricular Hypertrophy in Children on Peritoneal Dialysis

Borzych

Bakkaloğlu

Zaritsky

et al. 2011

Clinical Journal of the American Society of Nephrology

View full text Add to dashboard Cite

SummaryBackground and objectives Left ventricular hypertrophy (LVH) is an important end point of dialysis-associated cardiovascular disease. The objective of this study was to evaluate the effect of different pediatric reference systems on the estimated prevalence of LVH in children on chronic peritoneal dialysis (CPD).Design, setting, participants, & measurements Echocardiographic studies in 507 pediatric CPD patients from neonatal age to 19 years were collected in 55 pediatric dialysis units around the globe. We compared the prevalence of LVH on the basis of the traditional cutoff of left ventricular mass (LVM) index (Ͼ38.5 g/m 2.7 ) with three novel definitions of LVH that were recently established in healthy pediatric cohorts.Results Application of the new reference systems eliminated the apparently increased prevalence of LVH in young children obtained by the traditional fixed LVM index cutoff currently still recommended by consensus guidelines. However, substantial differences of LVM distribution between the new reference charts resulted in a marked discrepancy in estimated LVH prevalence ranging between 27.4% and 51.7%.Conclusions Although our understanding of the anthropometric determinants of heart size during childhood is improving, more consistent normative echocardiographic data from large populations of healthy children are required for cardiovascular diagnostics and research.

show abstract

Body Composition and Prevalence of Left Ventricular Hypertrophy

Cited by 92 publications

References 33 publications

Effect of Obesity and Insulin Resistance on Myocardial Substrate Metabolism and Efficiency in Young Women

Effect of Obesity and Insulin Resistance on Myocardial Substrate Metabolism and Efficiency in Young Women

Sex-Specific Determinants of Left Ventricular Mass in Pre-Diabetic and Type 2 Diabetic Subjects

Defining Left Ventricular Hypertrophy in Children on Peritoneal Dialysis

Contact Info

Product

Resources

About