Weight loss and progressive left ventricular remodelling: The Multi-Ethnic Study of Atherosclerosis (MESA)

Ravi V. Shah, Venkatesh L. Murthy, Siddique A. Abbasi, John Eng, Colin Wu, Pamela Ouyang, Raymond Y. Kwong, Allison Goldfine, David A. Bluemke, Joao Lima, Michael Jerosch-Herold

Research output: Contribution to journalArticlepeer-review

Abstract

Aims Impact of weight loss on cardiac structure has not been extensively investigated in large, multi-ethnic, community-based populations. We investigated the longitudinal impact of weight loss on cardiac structure by cardiac magnetic resonance (CMR). Methods and results 2351 participants in the Multi-Ethnic Study of Atherosclerosis (MESA) who underwent CMR at Exam 1 (2002) and Exam 5 (2011) were included. Primary outcomes were percentage change in LV mass (indexed to height) and LV mass-to-volume ratio (concentric LV remodelling). Multivariable linear regression was used to measure the association between outcomes and weight change. At median 9.4 years' follow-up, 639 individuals (27%) experienced >5% weight loss (median 6.9 kg) and 511 (22%) had >5% weight gain (median 6.4 kg). A >5% weight gain was associated with the greatest increase in LV mass (+5.4% median) and LV mass-to-volume ratio (+12.2% median). Adjusting for medications, hypertension/diabetes (and change in these risk factors), age, race and other risk factors, every 5% weight loss was associated with a 1.3% decrease in height-indexed LV mass and 1.3% decrease in LV mass-to-volume ratio (p<0.0001). There was no effect modification/confounding by age, race, gender or baseline BMI. Change in LV mass-to-volume ratio was roughly linear, specifically for modest degrees of weight loss ('10% to +10%). Change in LV mass was linear with weight loss, suggesting no threshold of weight loss is needed for LV mass regression. Conclusions In a large multi-ethnic population, weight loss is associated with beneficial effects on cardiac structure, independent of age, race, gender, BMI and obesity-related cardiometabolic risk. There is no threshold of weight loss required to produce these effects.

Original languageEnglish (US)
Pages (from-to)1408-1418
Number of pages11
JournalEuropean Journal of Preventive Cardiology
Volume22
Issue number11
DOIs
StatePublished - Nov 1 2015

Keywords

  • Obesity
  • cardiac magnetic resonance
  • weight loss

ASJC Scopus subject areas

  • Epidemiology
  • Cardiology and Cardiovascular Medicine

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