Adiposity, body composition and ventricular-arterial stiffness in the elderly: the Atherosclerosis Risk in Communities Study

作者：Fernandes Silva Miguel M; Shah Amil M; Claggett Brian; Cheng Susan; Tanaka Hirofumi; Silvestre Odilson M; Nadruz Wilson; Borlaug Barry A; Solomon Scott D^*

来源：European Journal of Heart Failure, 2018, 20(8): 1191-1201.

DOI：10.1002/ejhf.1188

• Obesity
• Adiposity
• Arterial stiffness
• Ventricular stiffness
• Aging

Aim Weight gain appears to accelerate age-related ventricular-arterial stiffening, which has been implicated in the development of heart failure (HF), but it is unclear whether body fat accumulation underpins this association. We evaluated the relationship of adiposity, using measures of body composition, with ventricular-arterial stiffness among the elderly in the community.
Methods and result Adiposity was accessed through body mass index (BMI), waist circumference, and body fat percentage. We studied the association of these measures with carotid-femoral pulse wave velocity (cfPWV), arterial elastance index (Eal), left ventricular (LV) end-systolic elastance index (Eesl) and LV end-diastolic elastance index (Eedl) in 5520 community-based, elderly Atherosclerosis Risk in Communities (ARIC) Study participants, who underwent echocardiography between 2011 and 2013. BMI and waist circumference were directly associated with Eal, Eedl and Eesl even after adjusting for age, sex, race, hypertension, diabetes mellitus, heart rate, prevalent coronary heart disease and HE. After further adjustment for BMI, body fat percentage demonstrated significant independent linear relationships with Eal [standardized beta coefficient (beta)=0.17, P<0.001], Eesl (beta=0.08, P=0.003) and Eedl (beta=0.20, P<0.001), and significant non-linear relationships with cfPWV (P=0.033).
Conclusion In this biracial community-based cohort, increased adiposity was associated with increased ventricular-arterial stiffness among the elderly and suggests a potential mechanism by which obesity might contribute to the development of HF.

• 出版日期2018-8