Associations of body size and composition with subclinical cardiac dysfunction in older individuals: the cardiovascular health study

Parveen K. Garg*, Mary L. Biggs, Jorge R. Kizer, Sanjiv J. Shah, Luc Djousse, Kenneth J. Mukamal

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

Background: Focused studies in younger to middle-aged populations have demonstrated a relationship between obesity and adverse cardiac mechanics. We examined whether measures of overall and central adiposity are associated with cardiac mechanics, assessed by speckle-tracking echocardiography, in an older population without prevalent coronary heart disease or heart failure. Methods: Body composition was measured by anthropometry, bioelectrical impedance, and dual-energy x-ray absorptiometry among participants in the Cardiovascular Health Study, a population-based cohort of adults aged 65 years or older. Systolic and diastolic cardiac mechanics were measured with speckle-tracking analysis of echocardiograms. Multi-variable adjusted linear regression models were used to investigate associations of body composition measures and cardiac mechanics. Results: Mean age for the 3525 included participants was 72.6 years, 39% were male, and 10% were black. Mean body-mass index (BMI) was 26.3 ± 4.4 kg/m2, waist circumference (WC) was 93.2 ± 12.9 cm, and waist-to-hip ratio was 0.92 ± 0.09. In fully adjusted analyses, all adiposity measures were associated with worse LV longitudinal strain, LV early diastolic strain rate, and left atrial reservoir strain; however, associations were strongest for WC and BMI (p < 0.001). When both BMI and WC were included in the same model, only WC remained associated with each cardiac strain measure. Conclusion: In this cross-sectional study of older adults, central obesity was most robustly associated with impaired left ventricular systolic and diastolic strain as well as left atrial strain. The adverse effects of central obesity appear to extend even into older age.

Original languageEnglish (US)
Pages (from-to)2539-2545
Number of pages7
JournalInternational Journal of Obesity
Volume45
Issue number12
DOIs
StatePublished - Dec 2021

Funding

This research was supported by contracts HHSN268201200036C, HHSN268200 800007C, HHSN268201800001C, N01HC55222, N01HC85079, N01HC85080, N01HC8 5081, N01HC85082, N01HC85083, N01HC85086, and grants. U01HL080295 and U01HL130114 from the National Heart, Lung, and Blood. Institute (NHLBI), with additional contribution from the National Institute of Neurological Disorders and Stroke (NINDS). Additional support was provided by R01AG023629 from the National Institute on Aging (NIA). A full list of principal CHS investigators and institutions can be found at CHS-NHLBI.org. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. SJS has received research grants from Actelion, AstraZeneca, Corvia, Novartis, and Pfizer; and has received consulting fees from Abbott, Actelion, AstraZeneca, Amgen, Axon Therapeutics, Bayer, Boehringer-Ingelheim, Bristol-Myers Squibb, Cardiora, CVRx, Cytokinetics, Eisai, GSK, Ionis, Ironwood, Lilly, Merck, MyoKardia, Novartis, Novo Nordisk, Pfizer, Regeneron, Sanofi, Shifamed, Tenax, and United Therapeutics. All other authors declare no competing interests.

ASJC Scopus subject areas

  • Nutrition and Dietetics
  • Medicine (miscellaneous)
  • Endocrinology, Diabetes and Metabolism

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