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December 10, 2020PLoS ONEOpen Access

Joint influences of obesity, diabetes, and hypertension on indices of ventricular remodeling: Findings from the community-based Framingham Heart Study

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Key result

Co-clustered obesity, hypertension, and diabetes linked to worse cardiac remodeling and ~34% greater LV mass.

  • P<0.01
  • n=5,741

Why the study?

Obesity, hypertension, and diabetes independently associate with cardiac remodeling and frequently co-cluster, but their conjoint and separate influences on cardiac remodeling have not been investigated.

Does the co-clustering of obesity, diabetes, and hypertension worsen indices of ventricular remodeling in a community-based cohort?

Population

5,741 Framingham Study participants

Comparison

Cross-classified categories of BMI, hypertension, and diabetes

Design

Community-based observational study

Authors

BJBeatrice von JeinsenRVRamachandran S. VasanDMDavid D. McManus

Discussion

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Member takes

Overview

May warrant closer monitoring in clustered patients; hypothesis-generating for intervention trials on remodeling.

Study Design

Type

Observational (n=5,741)

Structured PICO

Does the co-clustering of obesity, diabetes, and hypertension worsen indices of ventricular remodeling in a community-based cohort?

P
Population
5,741 Framingham Study participants (mean age 50 years, 55% women)
I
Intervention
Presence of obesity/overweight, hypertension, and/or diabetes
C
Comparator
Individuals with a normal BMI and without hypertension or diabetes
O
Outcome
Echocardiographic measurements of left ventricular (LV) mass (LVM), LV ejection fraction (LVEF), global longitudinal strain (GLS), mitral E/e', left atrial end-systolic (peak) dimension (LASD) and emptying fraction (LAEF)surrogate

Main Result

p-value: p=<0.01

Obesity, hypertension, and diabetes interact synergistically to worsen cardiac remodeling, particularly increasing LV mass and worsening global longitudinal strain.

Cite This Study

Jeinsen et al. (2020) conducted an observational in Cardiac remodeling (n=5,741). Obesity, hypertension, and diabetes vs. Normal BMI without hypertension or diabetes was evaluated on Left ventricular mass, LV ejection fraction, global longitudinal strain, and left atrial emptying fraction (p=<0.01). Co-clustering of obesity, hypertension, and diabetes synergistically worsened cardiac remodeling, increasing left ventricular mass by 34% and worsening global longitudinal strain by 9% (p<0.01).

synapsesocial.com/papers/6a164d9c512cb4f7828eb625https://doi.org/10.1371/journal.pone.0243199
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Also Consider

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  1. 1Association of Central Adiposity With Adverse Cardiac Mechanics2016 · 93 citations
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  3. 3Severe Obesity Impairs Systolic and Diastolic Heart Function – The Significance of Pulsed Tissue Doppler, Strain, and Strain Rate Parameters2013 · 30 citations
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  5. 5Relation of Left Ventricular Diastolic Properties to Systolic Function in Arterial Hypertension2000 · 135 citations