Visceral adiposity index and the risk of heart failure, late-life cardiac structure, and function in ARIC study

Author:

Xu Chaoguang12ORCID,Guo Yue12,Zhang Shaozhao12,Lai Yuhui12,Huang Mengting12,Zhan Rongjian3,Liu Menghui12,Xiong Zhenyu12,Huang Yiquan12,Huang Rihua12ORCID,Liao Xinxue12,Zhuang Xiaodong12,Cai Zhixiong4ORCID

Affiliation:

1. Cardiology Department, First Affiliated Hospital of Sun Yat-Sen University , 58 Zhongshan 2nd Road, Guangzhou 510080 , China

2. NHC Key Laboratory of Assisted Circulation, Sun Yat-Sen University , 58 Zhongshan 2nd Road, Guangzhou 510080 , China

3. Zhongshan School of Medicine, Sun Yat-Sen University

4. Cardiology Department, Shantou Central Hospital , 114 Waima Road, Shantou 515031 , China

Abstract

Abstract Background It is well established that obesity is associated with the risk of heart failure (HF). However, the data about relationship between visceral fat and the risk of HF are limited. Aims We aim to evaluate the association between visceral obesity assessed by visceral adiposity index (VAI) and incident HF and left ventricular (LV) structure and function in Atherosclerosis Risk in Communities (ARIC) study. Methods We included 12 161 participants (aged 54.1 ± 5.8 years) free of history of HF and coronary heart disease at baseline (1987–89) in ARIC study. We used multivariable Cox hazard regression models to assess the association between the VAI and incident HF. We further explored the effects of the VAI on LV geometry and function among 4817 participants with echocardiographic data using multivariable linear regression analysis and multinomial logistic regression. Results During a median follow-up of 22.5 years, a total of 1904 (15.7%) participants developed HF. After adjustment for traditional HF risk factors, 1 unit increase in the baseline VAI was associated with an 8% higher risk of incident HF [hazard ratio (HR): 1.08, 95% confidence interval (CI): 1.06–1.11]. Results were similar when participants were categorized by VAI tertiles. Compared with participants in the lowest tertile of VAI, those in the second tertile and third tertile had a greater risk of incident HF [HR (95% CI): 1.19 (1.05–1.34) and 1.42 (1.26–1.61), respectively]. For the analyses of the HF subtypes, the higher VAI was only associated with the risk of HF with preserved ejection fraction, not with HF with reduced ejection fraction. In addition, the greater VAI was associated with worse LV diastolic function and abnormal LV geometry including concentric remodelling, concentric hypertrophy, and eccentric hypertrophy. Conclusion This study shows that higher VAI was independently associated with the increased risk of incident HF and abnormal LV geometry and LV diastolic dysfunction.

Funder

National Natural Science Foundation of China

Guangdong Basic and Applied Basic Research Foundation

China Postdoctoral Science Special Foundation

Publisher

Oxford University Press (OUP)

Subject

Cardiology and Cardiovascular Medicine,Epidemiology

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