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Thoracic Visceral Adipose Tissue Area and Pulmonary Hypertension in Lung Transplant Candidates. The Lung Transplant Body Composition Study.

Publication ,  Journal Article
Al-Naamani, N; Pan, H-M; Anderson, MR; Torigian, DA; Tong, Y; Oyster, M; Porteous, MK; Palmer, S; Arcasoy, SM; Diamond, JM; Udupa, JK ...
Published in: Ann Am Thorac Soc
November 2020

Rationale: Obesity is associated with an increased risk of pulmonary hypertension (PH); however, regional adipose tissue deposition is heterogeneous with distinct cardiovascular phenotypes.Objectives: To determine the association of body mass index (BMI) and thoracic visceral and subcutaneous adipose tissue areas (VAT and SAT, respectively) with PH in patients with advanced lung disease referred for lung transplantation.Methods: We studied patients undergoing evaluation for lung transplantation at three centers from the Lung Transplant Body Composition Study. PH was defined as mean pulmonary artery pressure >20 mm Hg and pulmonary vascular resistance ≥3 Wood units. VAT and SAT were measured on chest computed tomography and normalized to height squared.Results: One hundred thirty-seven (34%) of 399 patients included in our study had PH. Doubling of thoracic VAT was associated with significantly lower pulmonary vascular resistance (β, -0.24; 95% confidence interval [95% CI], -0.46 to -0.02; P = 0.04), higher pulmonary arterial wedge pressure (β, 0.79; 95% CI, 0.32 to 1.26; P = 0.001), and decreased risk of PH (relative risk, 0.86; 95% CI, 0.74 to 0.99; P = 0.04) after multivariate adjustment. Vaspin levels were higher in patients without PH (median, 101.8 vs. 92.0 pg/ml; P < 0.001) but did not mediate the association between VAT and the risk of PH. SAT and BMI were not independently associated with risk of PH.Conclusions: Lower thoracic VAT was associated with a higher risk of PH in patients with advanced lung disease undergoing evaluation for lung transplantation. The role of adipokines in the pulmonary vascular disease remains to be evaluated.

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Published In

Ann Am Thorac Soc

DOI

EISSN

2325-6621

Publication Date

November 2020

Volume

17

Issue

11

Start / End Page

1393 / 1400

Location

United States

Related Subject Headings

  • Subcutaneous Fat
  • Lung Transplantation
  • Intra-Abdominal Fat
  • Hypertension, Pulmonary
  • Humans
  • Body Mass Index
  • Body Composition
  • 3202 Clinical sciences
  • 3201 Cardiovascular medicine and haematology
 

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Al-Naamani, N., Pan, H.-M., Anderson, M. R., Torigian, D. A., Tong, Y., Oyster, M., … Kawut, S. M. (2020). Thoracic Visceral Adipose Tissue Area and Pulmonary Hypertension in Lung Transplant Candidates. The Lung Transplant Body Composition Study. Ann Am Thorac Soc, 17(11), 1393–1400. https://doi.org/10.1513/AnnalsATS.202003-247OC
Al-Naamani, Nadine, Hao-Min Pan, Michaela R. Anderson, Drew A. Torigian, Yubing Tong, Michelle Oyster, Mary K. Porteous, et al. “Thoracic Visceral Adipose Tissue Area and Pulmonary Hypertension in Lung Transplant Candidates. The Lung Transplant Body Composition Study.Ann Am Thorac Soc 17, no. 11 (November 2020): 1393–1400. https://doi.org/10.1513/AnnalsATS.202003-247OC.
Al-Naamani N, Pan H-M, Anderson MR, Torigian DA, Tong Y, Oyster M, et al. Thoracic Visceral Adipose Tissue Area and Pulmonary Hypertension in Lung Transplant Candidates. The Lung Transplant Body Composition Study. Ann Am Thorac Soc. 2020 Nov;17(11):1393–400.
Al-Naamani, Nadine, et al. “Thoracic Visceral Adipose Tissue Area and Pulmonary Hypertension in Lung Transplant Candidates. The Lung Transplant Body Composition Study.Ann Am Thorac Soc, vol. 17, no. 11, Nov. 2020, pp. 1393–400. Pubmed, doi:10.1513/AnnalsATS.202003-247OC.
Al-Naamani N, Pan H-M, Anderson MR, Torigian DA, Tong Y, Oyster M, Porteous MK, Palmer S, Arcasoy SM, Diamond JM, Udupa JK, Christie JD, Lederer DJ, Kawut SM. Thoracic Visceral Adipose Tissue Area and Pulmonary Hypertension in Lung Transplant Candidates. The Lung Transplant Body Composition Study. Ann Am Thorac Soc. 2020 Nov;17(11):1393–1400.

Published In

Ann Am Thorac Soc

DOI

EISSN

2325-6621

Publication Date

November 2020

Volume

17

Issue

11

Start / End Page

1393 / 1400

Location

United States

Related Subject Headings

  • Subcutaneous Fat
  • Lung Transplantation
  • Intra-Abdominal Fat
  • Hypertension, Pulmonary
  • Humans
  • Body Mass Index
  • Body Composition
  • 3202 Clinical sciences
  • 3201 Cardiovascular medicine and haematology