Key result
In a multi-ethnic cohort, every 5% weight loss over a median 9.4 years was associated with a 1.3% decrease in height-indexed LV mass and a 1.3% decrease in LV mass-to-volume ratio (p<0.0001).
Why the study?
Does weight loss improve left ventricular mass and concentric remodeling in a multi-ethnic community-based population?
Cohort (n=2,351)
Yes
Does weight loss improve left ventricular mass and concentric remodeling in a multi-ethnic community-based population?
Effect estimate: 1.3% decrease per 5% weight loss
p-value: p=<0.0001
Weight loss is linearly associated with beneficial regression of left ventricular mass and concentric remodeling, independent of baseline cardiometabolic risk factors.
May support weight loss for LV remodeling in diverse adults; extends prior data but leaves causality open pending trials.
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.
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Shah et al. (2014) conducted a cohort in Community-based population (n=2,351). Weight loss vs. Weight gain or stable weight was evaluated on Percentage change in LV mass (indexed to height) and LV mass-to-volume ratio (concentric LV remodelling) (1.3% decrease per 5% weight loss, p=<0.0001). In a multi-ethnic cohort, every 5% weight loss over a median 9.4 years was associated with a 1.3% decrease in height-indexed LV mass and a 1.3% decrease in LV mass-to-volume ratio (p<0.0001).
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