Association of weight and body composition on cardiac structure and function in the ARIC study (Atherosclerosis Risk in Communities)

Natalie A. Bello, Susan Cheng, Brian Claggett, Amil M. Shah, Chiadi E. Ndumele, Gabriela Querejeta Roca, Angela B S Santos, Deepak Gupta, Orly Vardeny, David Aguilar, Aaron R. Folsom, Kenneth R. Butler, Dalane W. Kitzman, Josef Coresh, Scott D. Solomon

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51 Scopus citations


Background - Obesity increases cardiovascular risk. However, the extent to which various measures of body composition are associated with abnormalities in cardiac structure and function, independent of comorbidities commonly affecting obese individuals, is not clear. This study sought to examine the relationship between body mass index, waist circumference, and percent body fat with conventional and advanced measures of cardiac structure and function. Methods and Results - We studied 4343 participants of the ARIC study (Atherosclerosis Risk in Communities) who were aged 69 to 82 years, free of coronary heart disease and heart failure, and underwent comprehensive echocardiography. Increasing body mass index, waist circumference, and body fat were associated with greater left ventricular (LV) mass and left atrial volume indexed to height 2.7 in both men and women (P<0.001). In women, all 3 measures were associated with abnormal LV geometry, and increasing waist circumference and body fat were associated with worse global longitudinal strain, a measure of LV systolic function. In both sexes, increasing body mass index was associated with greater right ventricular end-diastolic area and worse right ventricular fractional area change (P≤0.001). We observed similar associations for both waist circumference and percent body fat. Conclusions - In a large, biracial cohort of older adults free of clinically overt coronary heart disease or heart failure, obesity was associated with subclinical abnormalities in cardiac structure in both men and women and with adverse LV remodeling and impaired LV systolic function in women. These data highlight the association of obesity and subclinical abnormalities of cardiac structure and function, particularly in women.

Original languageEnglish (US)
Article numbere002978
JournalCirculation: Heart Failure
Issue number8
StatePublished - Aug 1 2016

Bibliographical note

Funding Information:
The ARIC study is performed as a collaborative study supported National Heart, Lung, and Blood Institute (NHLBI) contracts (HHSN268201100005C, HHSN268201100006C, HHSN26820110 0007C, HHSN268201100008C, HHSN268201100009C, HHSN26 8201100010C, HHSN268201100011C, and HHSN268201100012C). This work was also supported NHLBI cooperative agreement NHLBI-HC-11-08 (Brigham and Women's Hospital). Support was provided for NAB by the NHLBI training grant (T32 HL007374- 34). Dr Santos acknowledges support from CAPES grant 0281-12-3 (Brazil). Dr Cheng is supported in part by R00-HL-107642 and the Ellison Foundation. Dr Shah is supported in part by K08-HL-116792.

Publisher Copyright:
© 2016 American Heart Association, Inc.


  • atherosclerosis
  • body mass index
  • echocardiography
  • obesity
  • ventricular remodeling


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