Low cardiorespiratory fitness (CRF), high body mass index, and excess visceral adiposity are each associated with impairment in left ventricular (LV) peak circumferential strain (Ecc), an intermediate phenotype that precedes the development of clinical heart failure (HF). However, the association of regional fat distribution and CRF with Ecc independent of each other and other potential confounders is not known. Participants from the Dallas Heart Study Phase 2 who underwent dual energy X-ray absorptiometry assessment of regional fat distribution, CRF assessment by submaximal treadmill test, and Ecc quantification by tissue-tagged cardiovascular magnetic resonance were included in the analysis. The cross-sectional associations of measures of regional adiposity, namely visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and lower-body fat (LBF) with Ecc after adjustment for CRF and other potential confounders (independent variables) were assessed using multivariable linear regression analysis. The study included 1089 participants (55% female, 39% black). In the unadjusted analysis, higher VAT was associated with greater impairment in Ecc. After adjustment for baseline risk factors, CRF, parameters of LV structure and function, and other fat depots such as SAT and LBF, higher VAT remained associated with greater impairment in Ecc (β: 0.19, P = 0.002). SAT and LBF were not significantly associated with Ecc, however, CRF remained associated with Ecc in the fully adjusted model including all fat depots (β: − 0.15, P < 0.001). VAT and CRF are each independently associated with impairment in Ecc, suggesting that higher VAT burden and low CRF mediate pathological cardiac remodeling through distinct mechanisms.

中文翻译：

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局部肥胖、心肺健康和左心室应变：达拉斯心脏研究的分析

心肺健康（CRF）低、体重指数高和内脏脂肪过多均与左心室（LV）峰值周向应变（Ecc）受损有关，左心室（LV）峰值周向应变（Ecc）是临床心力衰竭（HF）发展之前的中间表型。然而，区域脂肪分布和 CRF 与 Ecc 之间的相互独立以及其他潜在混杂因素的关联尚不清楚。达拉斯心脏研究第 2 阶段的参与者接受了双能 X 射线吸收测定法评估区域脂肪分布、通过次最大跑步机测试进行 CRF 评估以及通过组织标记的心血管磁共振进行 Ecc 量化，这些参与者均纳入分析。在调整 CRF 和其他潜在混杂因素（自变量）后，评估了区域肥胖指标（即内脏脂肪组织 (VAT)、皮下脂肪组织 (SAT) 和下半身脂肪 (LBF)）与 Ecc 的横断面关联使用多元线性回归分析。该研究共有 1089 名参与者（55% 为女性，39% 为黑人）。在未经调整的分析中，较高的增值税与较大的 Ecc 损害相关。在调整基线风险因素、CRF、左心室结构和功能参数以及其他脂肪库（如 SAT 和 LBF）后，较高的增值税仍然与 Ecc 损伤较大相关（β：0.19，P = 0.002）。SAT 和 LBF 与 Ecc 不显着相关，但是，在包括所有脂肪库的完全调整模型中，CRF 仍然与 Ecc 相关（β：− 0.15，P < 0.001）。VAT 和 CRF 均与 Ecc 损伤独立相关，表明较高的 VAT 负担和较低的 CRF 通过不同的机制介导病理性心脏重塑。