Visceral adiposity and left ventricular mass and function in patients with aortic stenosis: the PROGRESSA study

Area of Science:

• Cardiology
• Metabolic Syndrome Research
• Medical Imaging

Background:

• Obesity, metabolic syndrome, and diabetes are linked to left ventricular hypertrophy (LVH) and dysfunction in aortic stenosis (AS).
• Understanding the role of body fat distribution in AS pathophysiology is crucial.

Purpose of the Study:

• To investigate the association between body fat amount and distribution with LVH and systolic dysfunction in AS patients.
• To differentiate the impact of total adiposity versus visceral adiposity on cardiac remodeling and function.

Main Methods:

• 124 AS patients from the PROGRESSA study underwent Doppler echocardiography and computed tomography (CT).
• LVH assessed by LV mass indexed for height(2.7); LV dysfunction by global longitudinal strain (GLS).
• CT quantified visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and total adipose tissue (TAT).

Main Results:

• BMI correlated strongly with total adipose tissue (TAT).
• Greater BMI, TAT, VAT, and VAT/TAT ratio associated with increased LV mass index.
• VAT/TAT ratio independently associated with reduced global longitudinal strain (GLS).

Conclusions:

• Total and visceral adiposity are independently linked to LVH in AS patients.
• LV systolic dysfunction is associated with excess visceral adiposity, not total obesity.
• Findings support interventional studies targeting visceral adiposity in AS.