Obesity-related ventricular remodelling is exacerbated in dilated and hypertrophic cardiomyopathy.

Autor:	Rayner JJ; Oxford Centre for Clinical Magnetic Resonance Research (OCMR), Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK., Abdesselam I; Oxford Centre for Clinical Magnetic Resonance Research (OCMR), Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK., d'Arcy J; Oxford Centre for Clinical Magnetic Resonance Research (OCMR), Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK., Myerson SG; Oxford Centre for Clinical Magnetic Resonance Research (OCMR), Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK., Neubauer S; Oxford Centre for Clinical Magnetic Resonance Research (OCMR), Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK., Watkins H; Radcliffe Department of Medicine, University of Oxford, Oxford, UK., Ferreira VM; Oxford Centre for Clinical Magnetic Resonance Research (OCMR), Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK., Rider OJ; Oxford Centre for Clinical Magnetic Resonance Research (OCMR), Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK.
Jazyk:	angličtina
Zdroj:	Cardiovascular diagnosis and therapy [Cardiovasc Diagn Ther] 2020 Jun; Vol. 10 (3), pp. 559-567.
DOI:	10.21037/cdt-19-587
Abstrakt:	Background: Obesity causes significant cardiac remodelling even in health, and yet the contribution of this maladaptation in the setting of an additional cardiomyopathic process is poorly understood. Cardiovascular magnetic resonance is the gold-standard tool for assessing cardiac geometry, especially in an obese population, and hence perfectly suited to investigate this important question. Methods: Using data from our extensive imaging registry (n=1,554), we documented the relationship between increasing BMI and left ventricular (LV) remodelling in patients with dilated (DCM; n=529) and hypertrophic cardiomyopathy (HCM; n=297), compared to the normal heart (n=728). Results: Regardless of cardiac status, increasing BMI resulted in similar increases in LV stroke volume (P>0.18). However, there was a difference in the degree of LV cavity dilatation associated with this change in stroke volume; when compared to normal hearts [increase in end-diastolic volume of 0.7 mL per unit of rising BMI (mL/kg/m 2 )], there was a threefold greater LV cavity dilatation in DCM (+2.2 mL/kg/m 2 ) and twofold greater in HCM (+1.9 mL/kg/m 2 , all P<0.04). Whilst obesity was related to LV hypertrophy in all groups (normal +1.3 g, DCM +2.2g, HCM +2.3 g/kg/m 2 , all P<0.001), additional obesity-related concentric LV remodelling only occurred in normal hearts and DCM (normal +0.006 vs. +0.003 mass:volume ratio, both P<0.001). Conclusions: In both DCM and HCM, the increase in stroke volume required by obesity appears to be achieved by excessive LV cavity dilatation. The impact of obesity on LV geometry was more pronounced in concomitant cardiovascular disease, and therefore carries potential to become an important therapeutic target in cardiomyopathy. Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/cdt-19-587). The series “The Use of Advanced Cardiac MRI in Heart Failure and Cardiac Hypertrophy” was commissioned by the editorial office without any funding or sponsorship. OJR served as the unpaid Guest Editor of the series. SN reports grants and personal fees from Cytokinetcs, grants from Boerhringer Ingelheim, outside the submitted work. The authors have no other conflicts of interest to declare. (2020 Cardiovascular Diagnosis and Therapy. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu