Central obesity: association with left ventricular dysfunction and mortality in the community

Area of Science:

• Cardiology
• Obesity Research
• Public Health

Background:

• Body fat distribution impacts cardiovascular disease risk.
• The association between obesity indices (BMI, WHR) and left ventricular (LV) dysfunction is not well understood.
• Central obesity (high WHR) may pose distinct risks compared to overall obesity (high BMI).

Purpose of the Study:

• To assess the association between waist-hip ratio (WHR) and body mass index (BMI) with LV dysfunction.
• To determine the relationship between WHR and BMI with mortality in a community cohort.
• To investigate if central obesity is a stronger predictor of cardiovascular outcomes than overall obesity.

Main Methods:

• Cross-sectional study of 2,042 men and women over 45 years old.
• Anthropometric measurements (BMI, WHR) and echocardiographic LV function assessment.
• Five-year prospective mortality follow-up.

Main Results:

• Increased WHR showed a stronger association with lower LV ejection fraction and LV diastolic dysfunction compared to BMI.
• WHR remained significantly associated with diastolic dysfunction after adjusting for cardiovascular risk factors.
• WHR, but not BMI, independently predicted all-cause mortality, an association attenuated by diastolic dysfunction.

Conclusions:

• Waist-hip ratio is a more significant correlate of LV dysfunction and mortality than BMI.
• Central obesity's increased mortality risk may be partly mediated by LV dysfunction, particularly diastolic dysfunction.
• These findings highlight the importance of body fat distribution in cardiovascular risk assessment.