Ratio of Skeletal Muscle Mass to Visceral Fat Area Is a Useful Marker for Assessing Left Ventricular Diastolic Dysfunction among Koreans with Preserved Ejection Fraction: An Analysis of the Random Forest Model

Figures

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  Figure 1. Important feature selection by random forest. The plot displays the features leading up to the left ventricular diastolic dysfunction in order of importance of each variable. Important variables are in green boxes, rejected variables are in blue boxes, and tentative variables are in pink boxes. SVR, ratio of skeletal muscle mass to visceral fat area; VFA, visceral fat area; BMI, body mass index; SMI, skeletal muscle mass index; DBP, diastolic blood pressure; SBP, systolic blood pressure; eGFR, estimated glomerular filtration rate; CAD, coronary artery disease; CVD, cerebrovascular disease.

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  Figure 2. Incremental prognostic value of the ratio of skeletal muscle mass to visceral fat area (SVR) in the prediction of left ventricular diastolic dysfunction. The addition of SVR to the model including established risk factors resulted in significant improvement in the prediction. P-value for model 1 vs. each of the other models. HTN, hypertension; DM, diabetes mellitus; SBP, systolic blood pressure; eGFR, estimated glomerular filtration rate; SMI, skeletal muscle mass index; BMI, body mass index; cNRI, continuous net reclassification index; IDI, integrated discrimination improvement; CI, confidence interval.

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  Figure 3. The receiver operating characteristic curves for predicting left ventricular diastolic dysfunction according to sex. Receiver operating characteristic curves in (A) men and (B) women. *P<0.05 for the comparison between the SVR’s area under the curve and other models’ areas under the curve are indicated by the symbol. SVR, ratio of skeletal muscle mass to visceral fat area; CI, confidence interval; WHR, waist-hip ratio; SMI, skeletal muscle mass index; BMI, body mass index.

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  Figure 4. Prevalence of left ventricular diastolic dysfunction (LVDD) across tertiles of the ratio of skeletal muscle mass to visceral fat area (SVR). Patients were divided into tertiles based on sex-specific SVR values. Prevalence of LVDD according to (A) sex, (B) presence of obesity, and (C) metabolically health patients. BMI, body mass index.