Gender-specific differences in left ventricular remodelling in obesity: insights from cardiovascular magnetic resonance imaging

Rider, Oliver J; Lewandowski, Adam J.; Nethononda, Richard; Petersen, Steffen E.; Francis, Jane M; Pitcher, Alex; Holloway, Cameron; Dass, Sairia; Banerjee, Rajarshi; Byrne, James P.; Leeson, Paul; Neubauer, Stefan

doi:10.1093/eurheartj/ehs341

Cited by 92 publications

(80 citation statements)

References 30 publications

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“…18 The intraobserver coefficient of variation for RV mass with this method is excellent (9% RV-end-diastolic volume [EDV] and 12% RV mass in this study), and in keeping with previously reported data from this group.…”

Section: Discussionsupporting

confidence: 90%

“…25 Potential mechanisms for this have focused on the LV, including concentric hypertrophy, 18 diastolic dysfunction, 16 impaired myocardial energetics, 26 and increased aortic stiffness, 27 all of which are present in obesity and are independent markers of elevated cardiovascular risk. Although relatively underinvestigated, RV hypertrophy is also present in obesity 9,10 and is emerging as another risk factor for heart failure and cardiovascular death.…”

Section: Discussionmentioning

confidence: 99%

“…Although sex-specific patterns of LV remodeling have been shown in obesity, 17,18 whether sex differences in RV remodeling exist in obesity is currently unknown. However, given the sex difference in mortality in obesity 1 and the evidence that RV hypertrophy is associated with increased mortality, a sex difference in the pattern of RV hypertrophy could contribute to the sex difference in mortality in obesity.…”

Section: Rider Et Al Rv Remodeling In Obesitymentioning

confidence: 99%

“…Interestingly, this pattern is consistent with findings in the LV, where we have previously reported concentric remodeling in men, and mixed eccentric and concentric remodeling in women. 18 …”

Section: Sex Differences In Rv Hypertrophy In Response To Increasing Bmimentioning

confidence: 99%

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Obese Subjects Show Sex-Specific Differences in Right Ventricular Hypertrophy

Rider

Lewis

Lewandowski

et al. 2015

Circ: Cardiovascular Imaging

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One of the potential reasons for the underinvestigation of RV remodeling in obesity lies in the fact that accurate 2-dimensional echocardiographic assessment of RV size and function is inherently more difficult as a result of the complexity of the shape of the RV, which, in contrast to the ellipsoidal shape of the LV, seems triangular, when viewed from the side, and crescentic, when viewed from above. This is hampered further by the increased difficulty of generating adequate acoustic windows in obesity. Despite these limitations, the majority of these studies have shown RV hypertrophy in obesity. [5][6][7][8] A few previous studies investigating RV geometry in obesity, have, in the main, not excluded subjects with obesityrelated comorbidities, such as hypertension, 9 which are known to have independent effects on RV mass.5 In contrast to echocardiography, cardiovascular magnetic resonance imaging is Background-As right ventricular (RV) remodeling in obesity remains underinvestigated, and the impact of left ventricular (LV) diastolic dysfunction on RV hypertrophy is unknown, we aimed to investigate whether (1) sex-specific patterns of RV remodeling exist in obesity and (2) LV diastolic dysfunction in obesity is related to RV hypertrophy. Methods and Results-Seven hundred thirty-nine subjects (women, n=345; men, n=394) without identifiable cardiovascular risk factors (body mass index [BMI], 15.3-59.2 kg/m 2 ) underwent cardiovascular magnetic resonance (1.5 T) to measure RV mass (g), RV end-diastolic volume (mL), RV mass/volume ratio, and LV diastolic peak filling rate (mL/s). All subjects were normotensive (average, 119±11/73±8 mm Hg), normoglycaemic (4.8±0.5 mmol/L), and normocholesterolaemic (4.8±0.9 mmol/L) at the time of scanning. Across both sexes, there was a moderately strong positive correlation between BMI and RV mass (men, +0.8 g per BMI point increase; women, +1.0 g per BMI point increase; both P<0.001). Whereas women exhibited RV cavity dilatation (RV end-diastolic volume, +1.0 mL per BMI point increase; P<0.001), BMI was not correlated with RV end-diastolic volume in men (R=0.04; P=0.51). Concentric RV remodeling was present in both sexes, with RV mass/volume ratio being positively correlated to BMI (men, R=0.41; women, R=0.51; both P<0.001

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Rider Et Al Rv Remodeling In Obesitymentioning

confidence: 99%

Section: Sex Differences In Rv Hypertrophy In Response To Increasing Bmimentioning

confidence: 99%

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Obese Subjects Show Sex-Specific Differences in Right Ventricular Hypertrophy

Rider

Lewis

Lewandowski

et al. 2015

Circ: Cardiovascular Imaging

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“…Increased left ventricular mass index is an independent predictor for cardiovascular morbidity and mortality. 18 The average 19-g-higher left ventricular mass in young adults born preterm is equivalent to that associated with a 9-kg/m 2 increase in body mass index 19 and in longitudinal studies would equate to a >50% increased risk of cardiovascular clinical events in later adult life. 20,21 The major cardiovascular risk previously identified in those born preterm is their higher blood pressure, 9 which could have accounted for a proportion of the increased left ventricular mass.…”

Section: Discussionmentioning

confidence: 99%

Preterm Heart in Adult Life

et al. 2013

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Background— Preterm birth leads to an early switch from fetal to postnatal circulation before completion of left ventricular in utero development. In animal studies, this results in an adversely remodeled left ventricle. We determined whether preterm birth is associated with a distinct left ventricular structure and function in humans. Methods and Results— A total of 234 individuals 20 to 39 years of age underwent cardiovascular magnetic resonance. One hundred two had been followed prospectively since preterm birth (gestational age=30.3±2.5 week; birth weight=1.3±0.3 kg), and 132 were born at term to uncomplicated pregnancies. Longitudinal and short-axis cine images were used to quantify left ventricular mass, 3-dimensional geometric variation by creation of a unique computational cardiac atlas, and myocardial function. We then determined whether perinatal factors modify these left ventricular parameters. Individuals born preterm had increased left ventricular mass (66.5±10.9 versus 55.4±11.4 g/m 2 ; P <0.001) with greater prematurity associated with greater mass ( r = −0.22, P =0.03). Preterm-born individuals had short left ventricles with small internal diameters and a displaced apex. Ejection fraction was preserved ( P >0.99), but both longitudinal systolic (peak strain, strain rate, and velocity, P <0.001) and diastolic (peak strain rate and velocity, P <0.001) function and rotational (apical and basal peak systolic rotation rate, P =0.05 and P =0.006; net twist angle, P =0.02) movement were significantly reduced. A diagnosis of preeclampsia during the pregnancy was associated with further reductions in longitudinal peak systolic strain in the offspring ( P =0.02, n=29). Conclusions— Individuals born preterm have increased left ventricular mass in adult life. Furthermore, they exhibit a unique 3-dimensional left ventricular geometry and significant reductions in systolic and diastolic functional parameters. Clinical Trial Registration— URL: http://www.clinicaltrials.gov . Unique identifier: NCT01487824.

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Obesity and its cardiovascular effects

Ortega-Loubón

Fernández-Molina

Singh

et al. 2019

Diabetes Metabolism Res

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Obesity is described in terms of body fat percentage or body mass index (BMI), despite the fact that these measures do not give full insight about the body fat distribution. It is presently a consistently growing universal challenge since it has tripled in the last 10 years, killing approximately 28 million people each year. In this review, we aim to clarify the different results of obesity on the working and physiology of the cardiovascular system and to reveal changes in the obesity "paradox"-a variety of cardiovascular outcomes in typical/overweight people. Central fat build-up in ordinary/overweight populaces has been related to expanded occurrences of myocardial infarction, heart failure, or all-cause mortality when contrasted with the obese populace. These discoveries are additionally clarified as the abundance and prolonged vulnerability to free fatty acids (FFAs) in obesity. This has been believed to cause the myocardial substrate to move from glucose to FFAs digestion, which causes lipid gathering in cardiomyocytes, spilling over to other lean tissues, and prompting a general atherogenic impact. This cardiomyocyte lipid aggregation has been demonstrated to cause insulin resistance and cardiovascular hypertrophy, and to lessen the heart functions in general. There is a proof backing the fact that fat tissue is not only an energy reservoir, it also coordinates hormones and proinflammatory cytokines and deals with the energy transition of the body by putting away abundant lipids in diverse tissues.

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Gender-specific differences in left ventricular remodelling in obesity: insights from cardiovascular magnetic resonance imaging

Cited by 92 publications

References 30 publications

Obese Subjects Show Sex-Specific Differences in Right Ventricular Hypertrophy

Obese Subjects Show Sex-Specific Differences in Right Ventricular Hypertrophy

Preterm Heart in Adult Life

Obesity and its cardiovascular effects

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