Aims: To quantify metabolic impairment via a one-factor approach with confirmatory factor analysis (CFA) including MRI-derived visceral and subcutaneous adipose tissues and to associate it with... Show moreAims: To quantify metabolic impairment via a one-factor approach with confirmatory factor analysis (CFA) including MRI-derived visceral and subcutaneous adipose tissues and to associate it with diastolic dysfunction. Methods: In this cross-sectional analysis, 916 participants (53% female, mean age (SD): 56 (6)) underwent abdominal and cardiovascular MRI. With CFA a metabolic-load factor of metabolic-syndrome variables and visceral and subcutaneous adipose tissues was constructed. A piecewise structural equation model approach with adjustment for confounding factors was used to determine associations with left-ventricular diastolic function, cardiac morphology and hemodynamics. Results: Model fitting excluding blood pressure and waist circumference but including visceral and subcutaneous adipose tissues, fasting glucose, HDL-c and triglycerides was used to construct the metabolic-load factor. Evaluating measurement invariance demonstrated sex-specificity. Change in mitral early/late peak filling rate ratio was -0.12 for both males [-0.20; -0.05, p > 0.05] and females [-0.17; -0.07, p > 0.001] per SD of metabolicload factor. Change in deceleration time of mitral early filling was -11.83 ms in females [-17.38; -6.27] per SD of metabolic-load factor. Conclusion: A single latent metabolic-load factor via CFA including MRI-derived adipose tissues increased sensitivity for metabolic impairment obsoleting waist circumference and is associated with a decreased leftventricular diastolic function, more apparent in females than in males. Show less
The objectives of this thesis were to elucidate the pathogenesis of metabolic heart disease, evaluate the associated changes in myocardial structure and contractile function, and determine the long... Show moreThe objectives of this thesis were to elucidate the pathogenesis of metabolic heart disease, evaluate the associated changes in myocardial structure and contractile function, and determine the long-term prognostic implications of subclinical myocardial dysfunction on all-cause mortality. Show less
Aims We aimed to evaluate the associations of body fat distribution with cardiovascular function and geometry in the middle-aged general population.Methods and results Four thousand five hundred... Show moreAims We aimed to evaluate the associations of body fat distribution with cardiovascular function and geometry in the middle-aged general population.Methods and results Four thousand five hundred and ninety participants of the UK Biobank (54% female, mean age 61.1 +/- 7.2 years) underwent cardiac magnetic resonance for assessment of left ventricular (LV) parameters [end-diastolic volume (EDV), ejection fraction (EF), cardiac output (CO), and index (CI)] and magnetic resonance imaging for body composition analysis [subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT)]. Body fat percentage (BF%) was assessed by bioetectrical impedance. Linear regressions were performed to assess the impact of visceral (VAT) and general (SAT and BF%) obesity on cardiac function and geometry. Visceral obesity was associated with a smaller EDV [VAT: beta -1.74 (-1.15 to -2.33)1, lower EF NAT: beta -0.24 (-0.12 to -0.35), SAT: beta 0.02 (-0.04 to 0.08), and BF%: beta 0.02 (-0.02 to 0.06)] and the strongest negative association with CI [VAT: beta -0.05 (-0.06 to -0.04), SAT: beta -0.02 (-0.03 to -0.01), and BF% beta -0.01 (-0.013 to -0.007)]. In contrast, general obesity was associated with a larger EDV [SAT: beta 1.01 (0.72-1.30), BF%: beta 0.37 (0.23-0.51)] and a higher CO [SAT: beta 0.06 (0.05-0.07), BF%: beta 0.02 (0.01-0.03)]. In the gender-specific analysis, only men had a significant association between VAT and EF [beta -0.35 (-0.19 to -0.51)].Conclusions Visceral obesity was associated with a smaller LV EDV and subclinical lower LV systolic function in men, suggesting that visceral obesity might play a more important role compared to general obesity in LV remodelling. Show less
