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Adiposity and Incident Heart Failure and its Subtypes: MESA (Multi-Ethnic Study of Atherosclerosis).

Publication ,  Journal Article
Rao, VN; Zhao, D; Allison, MA; Guallar, E; Sharma, K; Criqui, MH; Cushman, M; Blumenthal, RS; Michos, ED
Published in: JACC Heart Fail
December 2018

OBJECTIVES: This study sought to compare various measures of adiposity with risk for incident hospitalized heart failure (HF) with preserved ejection fraction (HFpEF) and reduced ejection fraction (HFrEF). BACKGROUND: Obesity is a risk factor for HF, particularly HFpEF. It is unknown which measures of adiposity, including anthropometrics and computed tomography (CT)-measured fat area, are most predictive of HF subtypes. METHODS: The authors studied 1,806 participants of the MESA (Multi-Ethnic Study of Atherosclerosis) study without baseline cardiovascular disease who underwent anthropometrics (body mass index [BMI] and waist circumference) and an abdominal CT. Subcutaneous and visceral adipose tissue (VAT) were measured from a single CT slice at L2-L3. Cox hazard models were used to examine associations of adiposity with incident hospitalized HFpEF and HFrEF events. Fully adjusted models included demographics, HF risk factors, and N-terminal pro-B-type natriuretic peptide. RESULTS: Over a mean follow-up of 11 years, there were 34 HFpEF and 36 HFrEF events. The fully adjusted hazard ratio (95% confidence interval [CI]) per 1-SD higher of each anthropometric and CT-measured adiposity measures for incident HFpEF were as follows: BMI HR: 1.66; 95% CI: 1.12 to 2.45; waist circumference HR: 1.59; 95% CI: 1.05 to 2.40; and VAT HR: 2.24; 95% CI: 1.44 to 3.49. None of these adiposity measures were associated with HFrEF. Even among overweight/obese adults (BMI ≥25 kg/m2), assessment of VAT (per 1-SD) was strongly associated with HFpEF (HR: 2.78; 95% CI: 1.62 to 4.76). Subcutaneous adipose tissue was neither associated with HFpEF nor HFrEF. CONCLUSIONS: In a multiethnic cohort free of cardiovascular disease, CT-measured VAT was independently associated with incident hospitalized HFpEF but not HFrEF. Measuring visceral fat at the time of CT imaging for other indications may offer additional prognostication of HF risk. (Multi-Ethnic Study of Atherosclerosis [MESA]; NCT00005487).

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Published In

JACC Heart Fail

DOI

EISSN

2213-1787

Publication Date

December 2018

Volume

6

Issue

12

Start / End Page

999 / 1007

Location

United States

Related Subject Headings

  • Tomography, X-Ray Computed
  • Stroke Volume
  • Humans
  • Heart Failure
  • Ethnicity
  • Body Mass Index
  • Atherosclerosis
  • Anthropometry
  • Adiposity
  • Adipose Tissue
 

Citation

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ICMJE
MLA
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Rao, V. N., Zhao, D., Allison, M. A., Guallar, E., Sharma, K., Criqui, M. H., … Michos, E. D. (2018). Adiposity and Incident Heart Failure and its Subtypes: MESA (Multi-Ethnic Study of Atherosclerosis). JACC Heart Fail, 6(12), 999–1007. https://doi.org/10.1016/j.jchf.2018.07.009
Rao, Vishal N., Di Zhao, Matthew A. Allison, Eliseo Guallar, Kavita Sharma, Michael H. Criqui, Mary Cushman, Roger S. Blumenthal, and Erin D. Michos. “Adiposity and Incident Heart Failure and its Subtypes: MESA (Multi-Ethnic Study of Atherosclerosis).JACC Heart Fail 6, no. 12 (December 2018): 999–1007. https://doi.org/10.1016/j.jchf.2018.07.009.
Rao VN, Zhao D, Allison MA, Guallar E, Sharma K, Criqui MH, et al. Adiposity and Incident Heart Failure and its Subtypes: MESA (Multi-Ethnic Study of Atherosclerosis). JACC Heart Fail. 2018 Dec;6(12):999–1007.
Rao, Vishal N., et al. “Adiposity and Incident Heart Failure and its Subtypes: MESA (Multi-Ethnic Study of Atherosclerosis).JACC Heart Fail, vol. 6, no. 12, Dec. 2018, pp. 999–1007. Pubmed, doi:10.1016/j.jchf.2018.07.009.
Rao VN, Zhao D, Allison MA, Guallar E, Sharma K, Criqui MH, Cushman M, Blumenthal RS, Michos ED. Adiposity and Incident Heart Failure and its Subtypes: MESA (Multi-Ethnic Study of Atherosclerosis). JACC Heart Fail. 2018 Dec;6(12):999–1007.
Journal cover image

Published In

JACC Heart Fail

DOI

EISSN

2213-1787

Publication Date

December 2018

Volume

6

Issue

12

Start / End Page

999 / 1007

Location

United States

Related Subject Headings

  • Tomography, X-Ray Computed
  • Stroke Volume
  • Humans
  • Heart Failure
  • Ethnicity
  • Body Mass Index
  • Atherosclerosis
  • Anthropometry
  • Adiposity
  • Adipose Tissue