Direct, inflammation-mediated and blood-pressure-mediated effects of total and abdominal adiposity on diastolic function: EPIPorto study

• Type: Article in International Scientific Journal
• Date: 2015

Authors

Fontes-Carvalho R (Author) FMUP; Goncalves, A (Author) Other; Severo M (Author) FMUP; Lourenco, P (Author) FMUP; Goncalves, FR (Author) Other; Bettencourt P (Author) FMUP; Leite-Moreira AF (Author) FMUP; Azevedo A (Author) FMUP

Journal

Title: International Journal of Cardiology

Vol. 191

Pages: 64-70

ISSN: 0167-5273

Publisher: Elsevier

Indexing

ISI Web of Knowledge - 5 Citations

Scopus - 6 Citations

Other information

Authenticus ID: P-00G-BPZ

DOI: 10.1016/j.ijcard.2015.04.250

Abstract (EN): Background: Obesity has been associated with subclinical diastolic dysfunction and increased risk of heart failure. Our aims were to evaluate the age-and sex-specific role of total and abdominal adiposity on diastolic function and to assess the direct and indirect pathophysiological mechanisms involved in this association. Methods and results: Within a population-based study (EPIPorto), a total of 1063 individuals aged >= 45 years (62% female; 62.4 +/- 10.6 years) were evaluated using echocardiography, anthropometrics, electrical bioimpedance and blood tests. Diastolic function was assessed with using EAE/ASE consensus criteria. Worse diastolic function grades were associated with increased BMI, fat mass % and waist-to-height ratio (p for trend <0.001). The inverse association between adiposity and diastolic function was stronger in men and in the younger population. In multivariate analysis, waist-to-height ratio (per cm/cm) was associated with reduced E' velocity (adjusted beta:-14.4; 95% CI:-21.1 to -7.6; p < 0.001) and increased E/E' ratio (adjusted beta: 9.7, 95% CI: 5.4-10.0; p < 0.001), among men <65 years. Both direct and indirect mechanisms were involved in the E' velocity decrease by waist-to-height ratio in participants <65 years. The effect was mainly direct in men (81.3%), while it was mostly indirect in women, through systolic blood pressure (50.8%) and inflammation (15.1%). Conclusions: Adiposity, especially abdominal, was associated with worse diastolic function. This association was more important in men and in the younger population. The causal mechanisms involved were sex-specific, with mostly direct effects among men and blood-pressure-mediated among women.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 7