Associations Between Metabolic Dysregulation and Stage B Heart Failure in Hispanic Populations

BACKGROUND: Left ventricular structural abnormalities (concentric left ventricular remodeling [CR] or left ventricular hypertrophy [LVH]) and left ventricular diastolic dysfunction (LVDD) are key components of clinical diastolic heart failure (HF) and are associated with cardiometabolic risk factors, which are highly prevalent in Mexican Americans. OBJECTIVES: This study aimed to determine the prevalence of subclinical LV structural abnormalities (LVH or CR) and LVDD (Stage B HF) in a sample of asymptomatic Hispanics/Latinos and to examine the cardiometabolic determinants of these abnormalities. METHODS: Demographic, metabolic biomarkers, and body composition data were obtained in 1128 participants (57.8% females, mean age 52.6 ± 0.8 years) from the Cameron County Hispanic Cohort study. Abnormalities in cardiac structure and function were evaluated using transthoracic echocardiography. Visceral fat tissue was estimated utilizing dual-energy x-ray absorptiometry. Weighted logistic regression analyses were conducted while adjusting for demographic and clinical covariates. RESULTS: Weighted prevalence rates of LV structural abnormalities (55.9% ± 2.2%) and LVDD (19.6% ± 2.0%) were high. In adjusted models, age, body mass index (BMI), hypertension, and metabolic syndrome were associated with CR, LVH, or LVDD. In women, but not men, higher visceral adiposity and the presence of metabolic syndrome were associated with CR or LVH. CONCLUSIONS: There is a high prevalence of Stage B HF among Hispanics/Latinos. This study presents evidence of independent differential relationships of visceral adiposity, metabolic syndrome, and hypertension on CR, LVH, or LVDD in a Mexican American cohort. Targeted intervention strategies are important for preventing early cardiac abnormalities and mitigating the transition to symptomatic disease.