Journal ArticleDOI
Disparate effects of left ventricular geometry and obesity on mortality in patients with preserved left ventricular ejection fraction.
Carl J. Lavie,Richard V. Milani,Hector O. Ventura,Gustavo A. Cardenas,Mandeep R. Mehra,Franz H. Messerli +5 more
TLDR
In this article, the authors evaluated 30,920 patients with preserved ejection fraction, including 11,792 obese patients and 19,128 nonobese patients to determine the impact of 4 LV geometric patterns, including normal structure, concentric remodeling (CR), as well as eccentric or concentric hypertrophy and obesity on mortality during an average followup of 3.2 ± 1.4 years.Abstract:
Left ventricular (LV) geometry predicts cardiovascular events. Although obesity is a risk factor for cardiovascular diseases, studies have noted a paradox regarding obesity and prognosis. To our knowledge no studies have determined the impact of obesity on LV geometry as well as mortality in patients with preserved ejection fraction. We evaluated 30,920 patients with preserved ejection fraction, including 11,792 obese patients as well as 19,128 nonobese patients to determine the impact of 4 LV geometric patterns, including normal structure, concentric remodeling (CR), as well as eccentric or concentric hypertrophy and obesity on mortality during an average follow-up of 3.2 ± 1.4 years. Abnormal LV geometry occurred more commonly in obese than nonobese patients (49% vs 44%, p <0.0001 for the difference in the 4 patterns). In obese patients, CR was the most prevalent abnormal pattern (34%), with eccentric and concentric LV hypertrophy occurring in 7% and 8%, respectively, compared with nonobese patients (32%, 6%, and 6%, respectively). Overall mortality was considerably lower in obese than nonobese (3.9% vs 6.5%, p <0.0001). In both groups, progressive increases in mortality compared with normal structure occurred with CR, eccentric and concentric LV hypertrophy (obese patients 2.8%, 4.8%, 5.3%, and 6.9%, respectively; and nonobese patients 4.3%, 8.4%, 9.6%, and 11.8%, respectively). In conclusion, although an obesity paradox exists, in that obesity is associated with higher prevalence of structural abnormalities but lower mortality than in nonobese patients, our data demonstrate that LV geometric abnormalities are prevalent in both obese and nonobese patients with normal ejection fraction and are associated with progressive increases in mortality.read more
Citations
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Journal ArticleDOI
Pericardial, But Not Hepatic, Fat by CT Is Associated With CV Outcomes and Structure: The Multi-Ethnic Study of Atherosclerosis.
Ravi V. Shah,Amanda M. Anderson,Jingzhong Ding,Matthew J. Budoff,Oliver J Rider,Steffen E. Petersen,Majken K. Jensen,Manja Koch,Matthew A. Allison,Nadine Kawel-Boehm,Jessica Wisocky,Michael Jerosch-Herold,Kenneth J. Mukamal,Joao A.C. Lima,Venkatesh L. Murthy +14 more
TL;DR: In this article, the associations between local (pericardial) fat and incident cardiovascular disease (CVD) events and cardiac remodeling independent of markers of CVD, were determined.
Journal ArticleDOI
Association of obesity in early adulthood and middle age with incipient left ventricular dysfunction and structural remodeling: the CARDIA study (Coronary Artery Risk Development in Young Adults).
Satoru Kishi,Anderson C. Armstrong,Samuel S. Gidding,Laura A. Colangelo,Bharath Ambale Venkatesh,David R. Jacobs,J. Jeffery Carr,James G. Terry,Kiang Liu,David C. Goff,Joao A.C. Lima +10 more
TL;DR: Longstanding obesity from young adulthood to middle age is associated with impaired LV systolic and diastolic function assessed by conventional echocardiography, TDI, and STE in a large biracial cohort of adults age 43 to 55 years.
Journal Article
Obesity and hypertension, heart failure, and coronary heart disease-risk factor, paradox, and recommendations for weight loss.
TL;DR: This review summarizes the adverse effects of obesity on individual CVD risk factors; its role in the genesis of CVDs, including heart failure, coronary heart disease, and hypertension; and the obesity paradox observed in these populations and the potential underlying mechanisms behind this puzzling phenomenon and concludes with a discussion on the potential benefits of weight reduction.
Journal ArticleDOI
Impact of echocardiographic left ventricular geometry on clinical prognosis.
Carl J. Lavie,Carl J. Lavie,Dharmendrakumar A. Patel,Richard V. Milani,Hector O. Ventura,Sangeeta Shah,Yvonne Gilliland +6 more
TL;DR: Evidence supporting the benefits of LVH regression is examined, as well as evidence regarding the risk of CR progressing to LVH, as opposed to normalization of CR.
Journal ArticleDOI
Left Atrial Volume Index Predictive of Mortality Independent of Left Ventricular Geometry in a Large Clinical Cohort With Preserved Ejection Fraction
TL;DR: The LAVI significantly predicts mortality risk, independent of LV geometry, and adds to the overall mortality prediction in a large cohort of patients with preserved systolic function.
References
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Journal ArticleDOI
Recommendations for chamber quantification: a report from the American Society of Echocardiography's Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology.
Roberto M. Lang,Michelle Bierig,Richard B. Devereux,Frank A. Flachskampf,Elyse Foster,Patricia A. Pellikka,Michael H. Picard,Mary J. Roman,James B. Seward,Jack S. Shanewise,Scott D. Solomon,Kirk T. Spencer,Martin St. John Sutton,William J. Stewart +13 more
TL;DR: Members of the Chamber Quantification Writing Group are: Roberto M. Lang, MD, Fase, Michelle Bierig, MPH, RDCS, FASE, Richard B. Devereux,MD, Frank A. Flachskampf, MD and Elyse Foster, MD.
Journal ArticleDOI
Prevalence and Trends in Obesity Among US Adults, 1999-2000
TL;DR: The increases in the prevalences of obesity and overweight previously observed continued in 1999-2000, and increases occurred for both men and women in all age groups and for non-Hispanic whites, non- Hispanic blacks, and Mexican Americans.
Journal ArticleDOI
Echocardiographic assessment of left ventricular hypertrophy: Comparison to necropsy findings
Richard B. Devereux,Richard B. Devereux,Daniel R. Alonso,Daniel R. Alonso,Elizabeth M. Lutas,Elizabeth M. Lutas,Geoffrey J. Gottlieb,Geoffrey J. Gottlieb,E Campo,E Campo,Irene Sachs,Irene Sachs,Nathaniel Reichek,Nathaniel Reichek +13 more
TL;DR: To determine the accuracy of echocardiographic left ventricular (LV) dimension and mass measurements for detection and quantification of LV hypertrophy, results of blindly read antemortem e chocardiograms were compared with LV mass measurements made at necropsy in 55 patients.
Journal ArticleDOI
Prognostic Implications of Echocardiographically Determined Left Ventricular Mass in the Framingham Heart Study
TL;DR: The estimation of left ventricular mass by echocardiography offers prognostic information beyond that provided by the evaluation of traditional cardiovascular risk factors, and it is concluded that an increase in left Ventricular mass predicts a higher incidence of clinical events, including death, attributable to cardiovascular disease.
Journal ArticleDOI
Obesity as an independent risk factor for cardiovascular disease: a 26-year follow-up of participants in the Framingham Heart Study.
TL;DR: Intervention in obesity, in addition to the well established risk factors, appears to be an advisable goal in the primary prevention of CVD.