Greater Central Adiposity Is Associated With Poorer Left Atrial Function: The Atherosclerosis Risk in Communities...

Area of Science:

• Cardiology
• Public Health
• Gerontology

Background:

• Central adiposity, measured by waist circumference (WC), waist-to-hip ratio (WHR), and body mass index (BMI), is a growing public health concern.
• Left atrial (LA) function is crucial for cardiac health and is increasingly recognized as an early indicator of cardiovascular disease.
• Understanding the longitudinal impact of adiposity on LA function is essential for developing preventative strategies.

Purpose of the Study:

• To investigate the association between changes in WC, WHR, and BMI and LA function over time.
• To determine if longitudinal changes in adiposity measures are associated with impaired LA reservoir, conduit, or contractile function.

Main Methods:

• Analysis of 4008 participants from the Atherosclerosis Risk in Communities study with echocardiographic LA strain data.
• Adiposity measures (WC, WHR, BMI) assessed at two time points (V4 and V5) and categorized by change (consistently low, consistently elevated, increasing, decreasing).
• Multivariable linear regression models adjusted for cardiovascular risk factors, physical activity, and left ventricular (LV) size and function.

Main Results:

• Consistently elevated WC was associated with significantly worse LA reservoir and conduit function compared to consistently low WC.
• Increasing WC and consistently elevated WC were linked to reduced LA reservoir and conduit function.
• Consistently elevated WHR was significantly associated with worse LA reservoir and conduit function.
• Consistently elevated BMI was associated with significantly lower LA reservoir function.
• No significant associations were found between changes in WC, WHR, or BMI and LA contractile function.

Conclusions:

• Worsening central adiposity from mid-life to late life is independently associated with reduced LA reservoir and conduit function.
• These findings highlight the importance of maintaining a healthy adiposity profile throughout life to preserve LA function.
• Consistently low adiposity may play a key role in preventing atrial myopathy.