Key result
Higher BMI is linked to ~22% greater odds of myocardial fibrosis, alongside epicardial fat and reduced LV strain.
Why the study?
Overweight and obesity are major risk factors for adverse cardiovascular outcomes, but differences in CMR-assessed cardiac structure, function, strain, and epicardial adipose tissue volume and their relationship to myocardial fibrosis needed investigation.
Are overweight and obesity associated with adverse cardiac remodeling, impaired myocardial strain, and myocardial fibrosis in individuals without known cardiovascular disease?
Observational (n=192)
No
Are overweight and obesity associated with adverse cardiac remodeling, impaired myocardial strain, and myocardial fibrosis in individuals without known cardiovascular disease?
Effect estimate: OR 1.22 (95% CI 1.07-1.40)
Overweight and obesity are associated with early subclinical cardiac remodeling, impaired myocardial strain, and increased epicardial adipose tissue, which independently correlate with myocardial fibrosis.
Hypothesis-generating for BMI in myocardial fibrosis; leaves open causality and needs prospective validation before clinical use.
Overweight and obesity are major risk factors for adverse cardiovascular outcomes. Cardiac magnetic resonance (CMR) can detect subclinical cardiac dysfunction through myocardial strain and quantify epicardial adipose tissue volume (EATV). This study aimed to investigate the differences in cardiac structure, function, myocardial strain, and EATV among individuals with normal weight, overweight, and obesity using CMR, and to evaluate their value for myocardial fibrosis (LGE positivity). In this study, 192 subjects undergoing CMR were classified into control (n = 77), overweight (n = 37), and obesity (n = 78) groups based on body mass index (BMI). CMR-derived parameters included cardiac function, left ventricular global/segment strain (radial, circumferential, longitudinal), left atrial strain, EATV, and late gadolinium enhancement (LGE). Differences among groups were compared. Spearman correlation analyzed relationships between BMI, EATV, and strain parameters. Logistic regression and ROC curve analyses assessed factors independently associated with LGE positivity. Compared to the control group, the overweight and obesity groups showed significantly increased left ventricular volumes, mass, and EATV, but decreased left ventricular ejection fraction (LVEF), global longitudinal strain (GLS), and left atrial reservoir strain (εs), with the most pronounced changes in the obesity group. EATV was highly correlated with BMI (r = 0.72). Both BMI and EATV showed low-to-moderate inverse correlations with impaired myocardial strain parameters (|r| = 0.22–0.31). Multivariate logistic regression identified higher BMI (OR = 1.22, 95% CI:1.07–1.40), larger EATV (OR = 1.03, 95% CI:1.01–1.04), and lower left ventricular apical segment radial strain (A-PRS) (OR = 0.93, 95% CI:0.87–0.98) as factors independently associated with LGE positivity. Overweight and obesity are associated with adverse cardiac remodeling, subclinical systolic dysfunction, impaired myocardial strain, and increased EATV. BMI, EATV, and A-PRS are factors independently associated with myocardial fibrosis. These findings underscore the presence of early cardiac alterations in the overweight stage, highlighting the need for early cardiovascular risk assessment in this population.
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Liu et al. (2026) conducted an observational in Overweight and obesity (n=192). Overweight and obesity vs. Normal weight was evaluated on Myocardial fibrosis (LGE positivity) (OR 1.22, 95% CI 1.07-1.40). Higher BMI (OR 1.22), larger epicardial adipose tissue volume (OR 1.03), and lower left ventricular apical segment radial strain (OR 0.93) were independently associated with myocardial fibrosis.
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