Obesity promotes left ventricular concentric rather than eccentric geometric remodeling and hypertrophy independent of blood pressure

被引:104
作者
Woodiwiss, Angela J. [1 ]
Libhaber, Carlos D. [2 ]
Majane, Olebogeng H. I. [1 ]
Libhaber, Elena [2 ]
Maseko, Muzi [1 ]
Norton, Gavin R. [1 ]
机构
[1] Univ Witwatersrand, Cardiovasc Pathophysiol & Genom Res Unit, Sch Physiol, Fac Hlth Sci, Johannesburg, South Africa
[2] Univ Witwatersrand, Sch Med, Fac Hlth Sci, Johannesburg, South Africa
基金
英国医学研究理事会; 新加坡国家研究基金会;
关键词
D O I
10.1038/ajh.2008.252
中图分类号
R6 [外科学];
学科分类号
1002 ; 100210 ;
摘要
BACKGROUND As it is uncertain whether excess adiposity promotes primarily concentric or eccentric left ventricular hypertrophy (LVH), we aimed to determine at a population level, the independent relationship between waist circumference (WC) and LV geometric changes and the potential hemodynamic mechanisms thereof. METHODS We assessed the relations between WC and LV end-diastolic diameter (EDD), LV mean wall thickness (MWT = posterior + septal wall thickness/2), LV relative wall thickness (RWT = MWT/EDD), LV mass index (LVMI), concentric LVH (LVMI > 51 g/m(2.7) and RWT > 0.45), eccentric LVH (LVMI > 51 g/m2.7 and RWT < 0.45), or concentric LV remodeling (normal LVMI and RWT > 0.45), in 309 never treated for hypertension, randomly recruited adult participants with a high prevalence of excess adiposity (similar to 25% overweight; 38% obese). Pulse-wave analysis was performed to determine central artery blood pressures (BPs). Two hundred and thirty-one participants had high-quality ambulatory BP monitoring. RESULTS Approximately 7% of participants had concentric LVH, similar to 16% concentric LV remodeling, and similar to 15% eccentric LVH. After adjustments for potential confounders including conventional systolic BP (SBP), WC was related to MWT (partial r = 0.23, P = 0.0001), RWT (partial r = 0.13, P = 0.03), concentric LVH (P < 0.04), concentric LV remodeling (P = 0.02), but not with EDD or eccentric LVH (P = 0.91). Similar outcomes were noted after adjustments for central or 24-h SBP, and for conventional, central, or 24-h pulse pressure. Separate analysis in normotensive subjects revealed similar outcomes. CONCLUSIONS In a population sample with a high prevalence of obesity, excess adiposity promotes concentric, rather than eccentric LV geometric changes, effects which are independent of conventional, central artery or 24-h BP measured on a single occasion.
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收藏
页码:1144 / 1151
页数:8
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