Association Between Regional Adipose Tissue Distribution and Risk of Heart Failure Among Blacks

Abstract

Background: Obesity is highly prevalent among blacks and is associated with a greater risk of heart failure (HF). However, the contribution of regional adiposity depots such as visceral adipose tissue (VAT) and abdominal subcutaneous adipose tissue toward risk of HF in blacks is unknown. Methods and Results: We included 2602 participants (mean age: 59 years, 35% men) from the Jackson Heart Study without prevalent HF who underwent computed tomography quantification of VAT and subcutaneous adipose tissue during the second visit (2005–2009). The associations between different adiposity measures and HF were evaluated using adjusted Cox models. There were 122 incident HF events over a median follow-up of 7.1 years. Higher amounts of VAT were associated with greater risk of HF in age- and sex-adjusted analyses (hazard ratio [95% CI] per 1-SD higher VAT: 1.29 [1.09–1.52]). This association was attenuated and not significant after additional adjustment for traditional HF risk factors and body mass index. Overall obesity, represented by body mass index, was associated with higher risk of HF independent of risk factors and VAT (hazard ratio [95% CI] per 1-kg/m 2 higher body mass index: 1.06 [1.02–1.11]). Subcutaneous adipose tissue was not associated with risk of HF in adjusted analyses. Conclusions: In a community-dwelling black population, higher amounts of overall and visceral adiposity are associated with higher risk of HF. The association between VAT and HF risk in blacks may reflect differences in traditional HF risk factor burden. Future studies are needed to confirm this observation and clarify the independent role of different measures of adiposity on HF outcomes.

Relationship between low skeletal muscle mass, sarcopenic obesity and left ventricular diastolic dysfunction in Korean adults

“…Rao et al reported a significant effect of BMI, WC and CT‐measured visceral adipose tissue (VAT) on the risk of HFpEF in a longitudinal manner in black, white, Hispanic and Chinese‐American subjects 52 . Pandey et al found no association between higher VAT and risk of HF amongst blacks 53 . Thus, the relationship between body composition and diastolic dysfunction may differ amongst different ethnicities.…”

Regional adiposity and heart failure with preserved ejection fraction

“…The role of obesity in pathogenesis of HF, and particularly HFpEF, has drawn greater attention. 10,19,23,105 While anthropometrics are commonly used to categorize obesity at present, they are not always representative of excess regional adiposity. 38 Focus on quantifying regional distribution of adiposity may provide more insight into incidence and disease progression of an obese HFpEF phenotype.…”

Regional adiposity, cardiorespiratory fitness, and left ventricular strain: an analysis from the Dallas Heart Study

“…Although the mechanisms by which CRF and regional fat depots mediate HF risk are not well established, prior studies have reported epidemiological associations between CRF, visceral adiposity (VAT), and abnormal cardiac remodeling patterns. VAT has been associated with higher left ventricular (LV) mass and lower LV end diastolic volume (EDV) [ 5 , 9 ], while CRF has been associated with higher LV filling pressures and diastolic dysfunction [ 10 , 11 ]. These cardiac remodeling patterns may reflect intermediate phenotypes in the progression from at-risk to clinical HF [ 12 , 13 ].…”

“…LV peak systolic circumferential strain (E cc ) is a sensitive marker of abnormal cardiac remodeling and is independently associated with risk of HF [ 14 , 15 ]. CRF and regional adiposity have each been associated with impairment in E cc independent of BMI [ 5 , 16 ]. However, prior studies have not examined the association between regional fat distribution and subclinical myocardial dysfunction, independent of CRF, a potential confounder not accounted for in prior reports.…”