Rider, Oliver J.;
Lewis, Andrew J.M.;
Lewandowski, Adam J.;
Ntusi, Ntobeko;
Nethononda, Richard;
Petersen, Steffen E.;
Francis, Jane M.;
Pitcher, Alex;
Banerjee, Rajarshi;
Leeson, Paul;
Neubauer, Stefan
Obese Subjects Show Sex-Specific Differences in Right Ventricular Hypertrophy
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Media type:
E-Article
Title:
Obese Subjects Show Sex-Specific Differences in Right Ventricular Hypertrophy
Contributor:
Rider, Oliver J.;
Lewis, Andrew J.M.;
Lewandowski, Adam J.;
Ntusi, Ntobeko;
Nethononda, Richard;
Petersen, Steffen E.;
Francis, Jane M.;
Pitcher, Alex;
Banerjee, Rajarshi;
Leeson, Paul;
Neubauer, Stefan
Description:
<jats:sec>
<jats:title>Background—</jats:title>
<jats:p>As right ventricular (RV) remodeling in obesity remains underinvestigated, and the impact of left ventricular (LV) diastolic dysfunction on RV hypertrophy is unknown, we aimed to investigate whether (1) sex-specific patterns of RV remodeling exist in obesity and (2) LV diastolic dysfunction in obesity is related to RV hypertrophy.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Methods and Results—</jats:title>
<jats:p>
Seven hundred thirty-nine subjects (women, n=345; men, n=394) without identifiable cardiovascular risk factors (body mass index [BMI], 15.3–59.2 kg/m
<jats:sup>2</jats:sup>
) underwent cardiovascular magnetic resonance (1.5 T) to measure RV mass (g), RV end-diastolic volume (mL), RV mass/volume ratio, and LV diastolic peak filling rate (mL/s). All subjects were normotensive (average, 119±11/73±8 mm Hg), normoglycaemic (4.8±0.5 mmol/L), and normocholesterolaemic (4.8±0.9 mmol/L) at the time of scanning. Across both sexes, there was a moderately strong positive correlation between BMI and RV mass (men, +0.8 g per BMI point increase; women, +1.0 g per BMI point increase; both
<jats:italic>P</jats:italic>
<0.001). Whereas women exhibited RV cavity dilatation (RV end-diastolic volume, +1.0 mL per BMI point increase;
<jats:italic>P</jats:italic>
<0.001), BMI was not correlated with RV end-diastolic volume in men (
<jats:italic>R</jats:italic>
=0.04;
<jats:italic>P</jats:italic>
=0.51). Concentric RV remodeling was present in both sexes, with RV mass/volume ratio being positively correlated to BMI (men,
<jats:italic>R</jats:italic>
=0.41; women,
<jats:italic>R</jats:italic>
=0.51; both
<jats:italic>P</jats:italic>
<0.001). Irrespective of sex, the LV peak filling rate was negatively correlated with both RV mass (men,
<jats:italic>R</jats:italic>
=−0.43; women,
<jats:italic>R</jats:italic>
=−0.44; both
<jats:italic>P</jats:italic>
<0.001) and RV mass/volume ratio (men,
<jats:italic>R</jats:italic>
=−0.37; women,
<jats:italic>R</jats:italic>
=−0.35; both
<jats:italic>P</jats:italic>
<0.001).
</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Conclusions—</jats:title>
<jats:p>A sex difference in RV remodeling exists in obesity. Whereas men exhibit concentric RV remodeling, women exhibit a mixed pattern of eccentric and concentric remodeling. Regardless of sex, reduced LV diastolic function is associated with concentric RV remodeling.</jats:p>
</jats:sec>