Prospective associations between the trajectory of the Chinese visceral adiposity index and risk of new-onset heart failure

BACKGROUND: The Chinese Visceral Adiposity Index (CVAI), a straightforward surrogate measure of visceral fat, is significantly associated with the risk of cardiovascular disease (CVD) in the general population. This study aimed to evaluate the association of the trajectory of the Chinese visceral adiposity index with new-onset heart failure (HF) risk. METHODS: This prospective cohort study included 76,822 participants who were free of HF or cancer up to 2012. The CVAI was calculated using the age, body mass index, waist circumference, and metabolic parameters of the participants, and latent mixed modelling was used to identify the trajectory of CVAI during the exposure period (2006-2012). Cox proportional hazard models were used to calculate the hazard ratio (HR) and 95% confidence interval (CI) for incident HF of the trajectory groups. RESULTS: Five trajectory groups based on the changes in CVAI were identified. During a median follow-up period of 7.78 years, 1,480 participants developed HF. Compared with the Low-stable group, the HRs of HF in High-stable and High-increasing groups were 2.01 (1.11, 3.63) and 2.43 (1.28, 4.62), respectively. The correlations were strongest in participants < 60 years of age and those that did not have hypertension. Sensitivity analyses generated similar findings. CONCLUSION: Long-term high CVAI is associated with higher risk of HF, irrespective of conventional risk factors. The regular monitoring of CVAI may help identify individuals at high risk of HF in the general population.