Document Type : Original Article(s)

Authors

1 Assistant Professor, Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran

2 Professor, Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran

3 Assistant Professor, Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran

4 Assistant Professor, Department of Cardiology, School of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran

5 General Practitioner, Shahrekord University of Medical Sciences, Shahrekord, Iran

6 Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran

7 Associate Professor, Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

BACKGROUND: Obesity is a major risk factor for many diseases including cardiovascular diseases (CVDs). Recently, it has been shown that upper body obesity can predict CVDs per se. In this study, we aimed to determine the association between indicators of upper body obesity and echocardiographic indices.METHODS: In this cross-sectional study conducted in Hajar Hospital in Shahrekord, Iran, from March to August 2014, 80 healthy adults were included. Participants’ neck circumference (NC), waist circumference (WC), body mass index (BMI), and blood pressure were measured. Echocardiography was performed for all participants, and echocardiographic indices such as early (E’) and late (A') diastolic tissue velocity, early (E) and late (A) transmitral flow velocity, E/E’ ratio, pulmonary arterial pressure (PAP), and left atrial volume (LAV) were recorded. The association between these indices were investigated using bivariate Pearson correlation coefficient.RESULTS: For men, NC had a significant correlation with LAV, systolic blood pressure (SBP), diastolic blood pressure (DBP), PAP, and A', and a negative correlation with E′. WC had a significant correlation with LAV, SBP, and PAP, and a negative correlation with E′, while BMI had a significant correlation with LAV, PAP, SBP, A, and A’. For women, NC had a significant positive correlation with LAV, A, ejection fraction (EF), SBP, PAP, and A’, and a negative correlation with E′ and E/E′. WC had a significant positive correlation with LAV, DBP, PAP, A, A’, and a negative correlation with E′, while BMI had a significant correlation with LAV, EF, SBP, PAP, E’, A, and A’.CONCLUSION: The positive correlation of NC with SBP, A, and A', as well as NC, WC, and BMI with LAV and PAP in both sexes, and the negative correlation of NC with E′ show the importance of these measures in estimation of metabolic and cardiovascular risk factors. 

Keywords

  1. Kardys I, Deckers JW, Stricker BH, Vletter WB, Hofman A, Witteman J. Distribution of echocardiographic parameters and their associations with cardiovascular risk factors in the Rotterdam Study. Eur J Epidemiol 2010; 25(7): 481-90.
  2. Han SS, Cho GY, Park YS, Baek SH, Ahn SY, Kim S, et al. Predictive value of echocardiographic parameters for clinical events in patients starting hemodialysis. J Korean Med Sci 2015; 30(1): 44-53.
  3. Clearfield M, Pearce M, Nibbe Y, Crotty D,
  4. Wagner A. The "New Deadly Quartet" for cardiovascular disease in the 21st century: Obesity, metabolic syndrome, inflammation and climate change: How does statin therapy fit into this equation? Curr Atheroscler Rep 2014; 16(1): 380.
  5. Kuznetsova T, Herbots L, Lopez B, Jin Y, Richart T, Thijs L, et al. Prevalence of left ventricular diastolic dysfunction in a general population. Circ Heart Fail 2009; 2(2): 105-12.
  6. Kissebah AH, Vydelingum N, Murray R, Evans DJ, Hartz AJ, Kalkhoff RK, et al. Relation of body fat distribution to metabolic complications of obesity. J Clin Endocrinol Metab 1982; 54(2): 254-60.
  7. Stevens J. Obesity, fat patterning and cardiovascular risk. Adv Exp Med Biol 1995; 369: 21-7.
  8. Goodpaster BH, Krishnaswami S, Harris TB, Katsiaras A, Kritchevsky SB, Simonsick EM, et al. Obesity, regional body fat distribution, and the metabolic syndrome in older men and women. Arch Intern Med 2005; 165(7): 777-83.
  9. Preis SR, Massaro JM, Hoffmann U, D'Agostino RB Sr Levy D, Robins SJ, et al. Neck circumference as a novel measure of cardiometabolic risk: The Framingham Heart study. J Clin Endocrinol Metab 2010; 95(8): 3701-10.
  10. Ben-Noun L, Sohar E, Laor A. Neck circumference as a simple screening measure for identifying overweight and obese patients. Obes Res 2001; 9(8): 470-7.
  11. Ashwell M, Cole TJ, Dixon AK. Obesity: New insight into the anthropometric classification of fat distribution shown by computed tomography. Br Med J (Clin Res Ed) 1985; 290(6483): 1692-4.
  12. Wing RR, Jeffery RW, Burton LR, Thorson C, Kuller LH, Folsom AR. Change in waist-hip ratio with weight loss and its association with change in cardiovascular risk factors. Am J Clin Nutr 1992; 55(6): 1086-92.
  13. Haffner SM, Stern MP, Hazuda HP, Pugh J, Patterson JK. Do upper-body and centralized adiposity measure different aspects of regional body-fat distribution? Relationship to non-insulin-dependent diabetes mellitus, lipids, and lipoproteins. Diabetes 1987; 36(1): 43-51.
  14. Pouliot MC, Despres JP, Lemieux S, Moorjani S,
  15. Bouchard C, Tremblay A, et al. Waist circumference and abdominal sagittal diameter: Best simple anthropometric indexes of abdominal visceral adipose tissue accumulation and related cardiovascular risk in men and women. Am J Cardiol 1994; 73(7): 460-8.
  16. Ben-Noun LL, Laor A. Relationship between changes in neck circumference and cardiovascular risk factors. Exp Clin Cardiol 2006; 11(1): 14-20.
  17. Nishimura RA, Tajik AJ. Evaluation of diastolic filling of left ventricle in health and disease: Doppler echocardiography is the clinician's Rosetta Stone. J Am Coll Cardiol 1997; 30(1): 8-18.
  18. Jiamsripong P, Honda T, Reuss CS, Hurst RT, Chaliki HP, Grill DE, et al. Three methods for evaluation of left atrial volume. Eur J Echocardiogr 2008; 9(3): 351-5.
  19. Huxley R, Mendis S, Zheleznyakov E, Reddy S, Chan J. Body mass index, waist circumference and waist: Hp ratio as predictors of cardiovascular risk-a review of the literature. Eur J Clin Nutr 2010; 64(1): 16-22.
  20. de Koning L, Merchant AT, Pogue J, Anand SS. Waist circumference and waist-to-hip ratio as predictors of cardiovascular events: Meta-regression analysis of prospective studies. Eur Heart J 2007; 28(7): 850-6.
  21. Nyamdorj R, Qiao Q, Lam TH, Tuomilehto J, Ho SY, Pitkaniemi J, et al. BMI compared with central obesity indicators in relation to diabetes and hypertension in Asians. Obesity (Silver Spring) 2008; 16(7): 1622-35.
  22. Yusuf S, Hawken S, Ounpuu S, Bautista L, Franzosi MG, Commerford P, et al. Obesity and the risk of myocardial infarction in 27,000 participants from 52 countries: A case-control study. Lancet 2005; 366(9497): 1640-9.
  23. Van Gaal LF, Vansant GA, De Leeuw IH. Upper body adiposity and the risk for atherosclerosis. J Am Coll Nutr 1989; 8(6): 504-14.
  24. Kaplan NM. The deadly quartet. Upper-body obesity, glucose intolerance, hypertriglyceridemia, and hypertension. Arch Intern Med 1989; 149(7): 1514-20.