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Clinical Research in Cardiology

, Volume 107, Issue 10, pp 887–896 | Cite as

Obesity and metabolic features associated with long-term developing diastolic dysfunction in an initially healthy population-based cohort

  • Kénora Chau
  • Nicolas Girerd
  • Martin Magnusson
  • Zohra Lamiral
  • Erwan Bozec
  • Ludovic Merckle
  • Margret Leosdottir
  • Erasmus Bachus
  • Zied Frikha
  • João Pedro Ferreira
  • Jean-Pierre Després
  • Patrick Rossignol
  • Jean-Marc Boivin
  • Faiez Zannad
Original Paper

Abstract

Background

Diastolic dysfunction (DD) is increasingly common. However, its metabolic determinants are poorly known. This study aims to determine which metabolic and inflammatory features predict DD in initially healthy adults.

Methods

We prospectively analyzed the association between metabolic features and DD in 728 initially healthy adults aged 30–60 from Eastern France enrolled in the STANISLAS population-based cohort. Clinical and biological cardiovascular features were collected at baseline (1994–1995). DD was assessed twenty years later (2011–2016) by echocardiography using current international guidelines. For replication purposes, 1463 subjects from the Malmö Preventive Project cohort were analyzed.

Results

In the STANISLAS cohort, 191 subjects (26.2%) developed DD. In age-sex-adjusted logistic models, significant predictors of DD were body mass index (BMI, odds ratio for 1-standard-deviation increase (OR) 1.28, 95% CI 1.08–1.52), waist circumference (WC, OR 1.48, 95% CI 1.18–1.84), waist-hip ratio (OR 1.53, 95% CI 1.16–2.02), systolic blood pressure (OR 1.19, 95% CI 1.00–1.43) and triglycerides (TG, OR 1.18, 95% CI 1.00–1.40). Subjects with elevated WC (> 80th percentile) and TG (> 50th percentile) had a twofold higher DD risk (age-sex-adjusted odds ratio 2.00, 95% CI 1.20–3.31, P = 0.008), whereas no such interplay was observed for BMI. In the Malmö cohort, BMI was similarly associated with DD; participants with both elevated BMI and TG were at higher DD risk (age-sex-adjusted odds ratio 1.61, 95% CI 1.18–2.20, P = 0.002).

Conclusions

Subjects with elevated WC and TG may have a higher long-term DD risk. Prevention targeting visceral obesity may help reduce the incidence of DD.

Keywords

Diastolic dysfunction Visceral fat Triglycerides Blood pressure Healthy adults Cohort study 

Notes

Acknowledgements

The authors thank the staff of the “Centre d’Investigation Clinique INSERM 1433, Pierre Drouin” and the Centre de Ressources Biologiques (CRB) Lorrain. They also thank the staff of the “Centre de Médecine Preventive” in charge of the first three visits. They thank Mr. Pierre Pothier for editing this manuscript.

Funding

The STANISLAS study was supported by grants from the CHU de Nancy, the Lorraine region, the 6th EU-FP Network of Excellence Ingenious HyperCare (#LSHM-CT-2006-037093), the 7th EU-FP MEDIA (FP7 #261409), the HOMAGE (FP7 #305507), the FIBRO-TARGETS (FP7 #602904) projects, and the French National Research Agency (ANR-15-RHUS-0004). The Malmö study was supported by grants from the Wallenberg Centre for Molecular Medicine (ALFSKANE-675271) and the Medical Faculty (ALFSKANE-432021/436111) of Lund University, the Skåne University Hospital, the Crafoord Foundation, the Ernhold Lundstroms Research Foundation, the Region Skåne, the Hulda and Conrad Mossfelt Foundation, the Southwest Skåne´s Diabetes Foundation, the Kocksa foundation, the Research Funds of Region Skåne and the Swedish Heart and Lung foundation (2015-0322).

Compliance with ethical standards

Ethical standards

The Ethics Committee of the Lorraine region (Comité Consultatif de Protection des Personnes qui se prêtent à une Recherche Biomédicale de Lorraine, and Comité Consultatif de Protection des Personnes Est-III) approved the study, in agreement with French legislation on human biomedical research. Each subject gave his/her written informed consent to participate in this study.

Conflict of interest

The authors declare that they have no competing interests.

Supplementary material

392_2018_1259_MOESM1_ESM.docx (293 kb)
Supplementary material 1 (DOCX 292 KB)

References

  1. 1.
    Desai CS, Colangelo LA, Liu K, Jacobs DR Jr, Cook NL, Lloyd-Jones DM, Ogunyankin KO (2013) Prevalence, prospective risk markers, and prognosis associated with the presence of left ventricular diastolic dysfunction in young adults: the coronary artery risk development in young adults study. Am J Epidemiol 177:20–32CrossRefGoogle Scholar
  2. 2.
    Fischer M, Baessler A, Hense HW, Hengstenberg C, Muscholl M, Holmer S, Döring A, Broeckel U, Riegger G, Schunkert H (2003) Prevalence of left ventricular diastolic dysfunction in the community. Results from a Doppler echocardiographic-based survey of a population sample. Eur Heart J 24:320–328CrossRefGoogle Scholar
  3. 3.
    Achong N, Wahi S, Marwick TH (2009) Evolution and outcome of diastolic dysfunction. Heart 95:813–818CrossRefGoogle Scholar
  4. 4.
    Rosenberg MA, Manning WJ (2012) Diastolic dysfunction and risk of atrial fibrillation: a mechanistic appraisal. Circulation 126:2353–2362CrossRefGoogle Scholar
  5. 5.
    Redfield MM, Jacobsen SJ, Burnett JC Jr, Mahoney DW, Bailey KR, Rodeheffer RJ (2003) Burden of systolic and diastolic ventricular dysfunction in the community appreciating the scope of the heart failure epidemic. JAMA 289:194–202CrossRefGoogle Scholar
  6. 6.
    Libhaber CD, Woodiwiss AJ, Booysen HL, Maseko MJ, Majane OH, Sareli P, Norton GR (2014) Differential relationships of systolic and diastolic blood pressure with components of left ventricular diastolic dysfunction. J Hypertens 32:912–920CrossRefGoogle Scholar
  7. 7.
    Aksoy S, Durmuş G, Ozcan S, Toprak E, Gurkan U, Oz D, Canga Y, Karatas B, Duman D (2014) Is left ventricular diastolic dysfunction independent from presence of hypertension in metabolic syndrome? An echocardiographic study. J Cardiol 64:194–198CrossRefGoogle Scholar
  8. 8.
    De las Fuentes L, Brown AL, Mathews SJ, Waggoner AD, Soto PF, Gropler RJ, Dávila-Román VG (2007) Metabolic syndrome is associated with abnormal left ventricular diastolic function independent of left ventricular mass. Eur Heart J 28:553–559CrossRefGoogle Scholar
  9. 9.
    Ammar KA, Redfield MM, Mahoney DW, Johnson M, Jacobsen SJ, Rodeheffer RJ (2008) Central obesity: association with left ventricular dysfunction and mortality in the community. Am Heart J 156:975–981CrossRefGoogle Scholar
  10. 10.
    Després JP, Lemieux I (2006) Abdominal obesity and metabolic syndrome. Nature 444:881–887CrossRefGoogle Scholar
  11. 11.
    Paulus WJ, Tschöpe C (2013) A novel paradigm for heart failure with preserved ejection fraction: comorbidities drive myocardial dysfunction and remodeling through coronary microvascular endothelial inflammation. J Am Coll Cardiol 62:263–271CrossRefGoogle Scholar
  12. 12.
    Borlaug BA, Redfield MM, Melenovsky V, Kane GC, Karon BL, Jacobsen SJ, Rodeheffer RJ (2013) Longitudinal changes in left ventricular stiffness: a community-based study. Circ Heart Fail 6:944–952CrossRefGoogle Scholar
  13. 13.
    Wohlfahrt P, Redfield MM, Lopez-Jimenez F, Melenovsky V, Kane GC, Rodeheffer RJ, Borlaug BA (2014) Impact of general and central adiposity on ventricular-arterial aging in women and men. JACC Heart Fail 2:489–499CrossRefGoogle Scholar
  14. 14.
    Ferreira JP, Girerd N, Bozec E, Mercklé L, Pizard A, Bouali S, Eby E, Leroy C, Machu JL, Boivin JM, Lamiral Z, Rossignol P, Zannad F (2017) Cohort Profile: Rationale and Design of the 4th Visit of the STANISLAS (Suivi Temporaire Annuel Non-Invasif de la Santé des Lorrains Assurés Sociaux) Cohort—a familial longitudinal population-based cohort from the Nancy region of France. Int J Epidemiol In pressGoogle Scholar
  15. 15.
    Nagueh SF, Appleton CP, Gillebert TC, Marino PN, Oh JK, Smiseth OA, Waggoner AD, Flachskampf FA, Pellikka PA, Evangelisa A (2009) Recommendations for the evaluation of left ventricular diastolic function by echocardiography. Eur J Echocardiogr 10:165–193CrossRefGoogle Scholar
  16. 16.
    Frikha Z, Girerd N, Huttin O, Courand PY, Bozec E, Olivier A, Lamiral Z, Zannad F, Rossignol P (2015) Reproducibility in echocardiographic assessment of diastolic function in a population based study (the STANISLAS Cohort study). PLoS One 10:e0122336CrossRefGoogle Scholar
  17. 17.
    Garner C, Lecomte E, Visvikis S, Abergel E, Lathrop M, Soubrier F (2000) Genetic and environmental influences on left ventricular mass. A family study. Hypertension 36:740–746CrossRefGoogle Scholar
  18. 18.
    Leosdottir M, Willenheimer R, Plehn J, Borgquist R, Gudmundsson P, Harris TB, Launer LJ, Bjornsdottir H, Nilsson PM, Gudnason V (2010) Myocardial structure and function by echocardiography in relation to glucometabolic status in elderly subjects from 2 population-based cohorts: a cross-sectional study. Am Heart J 159:414–20.e4CrossRefGoogle Scholar
  19. 19.
    Girerd N, Pibarot P, Fournier D, Daleau P, Voisine P, O’Hara G, Després JP, Mathieu P (2009) Middle-aged men with increased waist circumference and elevated C-reactive protein level are at higher risk for postoperative atrial fibrillation following coronary artery bypass grafting surgery. Eur Heart J 30:1270–1278CrossRefGoogle Scholar
  20. 20.
    Greenberg AS, Obin MS (2006) Obesity and the role of adipose tissue in inflammation and metabolism. Am J Clin Nutr 83:461–465CrossRefGoogle Scholar
  21. 21.
    Yusuf S, Hawken S, Ounpuu S, Bautista L, Franzosi MG, Commerford P, Lang CC, Rumboldt Z, Onen CL, Lisheng L, Tanomsup S, Wangai P Jr, Razak F, Sharma AM, Anand SS; INTERHEART Study Investigators (2005) Obesity and the risk of myocardial infarction in 27,000 participants from 52 countries: a case-control study. Lancet 366:1640–1649CrossRefGoogle Scholar
  22. 22.
    See R, Abdullah SM, McGuire DK, Khera A, Patel MJ, Lindsey JB, Grundy SM, de Lemos JA (2007) The association of differing measures of overweight and obesity with prevalent atherosclerosis: the Dallas Heart Study. J Am Coll Cardiol 50:752–759CrossRefGoogle Scholar
  23. 23.
    Kosmala W, Jedrzejuk D, Derzhko R, Przewlocka-Kosmala M, Mysiak A, Bednarek-Tupikowska G (2012) Left ventricular function impairment in patients with normal-weight obesity: contribution of abdominal fat deposition, profibrotic state, reduced insulin sensitivity, and proinflammatory activation. Circ Cardiovasc Imaging 5:349–356CrossRefGoogle Scholar
  24. 24.
    Fox CS, Massaro JM, Hoffmann U, Pou KM, Maurovich-Horvat P, Liu CY, Vasan RS, Murabito JM, Meigs JB, Cupples LA, D’Agostino RB, Sr, Donnell CJ (2007) Abdominal visceral and subcutaneous adipose tissue compartments: association with metabolic risk factors in the Framingham Heart Study. O’ Circulation 116:39–48Google Scholar
  25. 25.
    Miller M, Stone NJ, Ballantyne C, Bittner V, Criqui MH, Ginsberg HN, Goldberg AC, Howard WJ, Jacobson MS, Kris-Etherton PM, Lennie TA, Levi M, Mazzone T, Pennathur S (2011) Triglycerides and cardiovascular disease: a scientific statement from the American Heart Association. Circulation 123:2292–2333CrossRefGoogle Scholar
  26. 26.
    Taube A, Schlich R, Sell H, Eckardt K, Eckel J (2012) Inflammation and metabolic dysfunction: links to cardiovascular diseases. Am J Physiol Heart Circ Physiol 302:2148–2165CrossRefGoogle Scholar
  27. 27.
    Jelic S, Lederer DJ, Adams T, Padeletti M, Colombo PC, Factor PH, Le Jemtel TH (2010) Vascular inflammation in obesity and sleep apnea. Circulation 121:1014–1021CrossRefGoogle Scholar
  28. 28.
    Greif M, von Ziegler F, Wakili R, Tittus J, Becker C, Helbig S, Laubender RP, Schwarz W, D’Anastasi M, Schenzle J, Leber AW, Becker A (2013) Increased pericardial adipose tissue is correlated with atrial fibrillation and left atrial dilatation. Clin Res Cardiol 102:555–562CrossRefGoogle Scholar
  29. 29.
    Eschalier R, Rossignol P, Kearney-Schwartz A, Adamopoulos C, Karatzidou K, Fay R, Mandry D, Marie PY, Zannad F (2014) Features of cardiac remodeling, associated with blood pressure and fibrosis biomarkers, are frequent in subjects with abdominal obesity. Hypertension 63:740–746CrossRefGoogle Scholar
  30. 30.
    Haq MA, Wong C, Mutha V, Anavekar N, Lim K, Barlis P, Hare DL (2014) Therapeutic interventions for heart failure with preserved ejection fraction: a summary of current evidence. World J Cardiol 6:67–76CrossRefGoogle Scholar
  31. 31.
    Tschöpe C, Birner C, Böhm M, Bruder O, Frantz S, Luchner A, Maier L, Störk S, Kherad B, Laufs U (2018) Heart failure with preserved ejection fraction: current management and future strategies: Expert opinion on the behalf of the Nucleus of the “Heart Failure Working Group” of the German Society of Cardiology (DKG). Clin Res Cardiol 107:1–19CrossRefGoogle Scholar
  32. 32.
    Nazare JA, Smith J, Borel AL, Alméras N, Tremblay A, Bergeron J, Poirier P, Després JP (2013) Changes in both global diet quality and physical activity level synergistically reduce visceral adiposity in men with features of metabolic syndrome. J Nutr 143:1074–1083CrossRefGoogle Scholar
  33. 33.
    Conroy RM, Pyörälä K, Fitzgerald AP, Sans S, Menotti A, De Backer G, De Bacquer D, Ducimetière P, Jousilahti P, Keil U, Njølstad I, Oganov RG, Thomsen T, Tunstall-Pedoe H, Tverdal A, Wedel H, Whincup P, Wilhelmsen L, Graham IM; SCORE project group (2003) Estimation of ten-year risk of fatal cardiovascular disease in Europe: the SCORE project. Eur Heart J 24:987–1003CrossRefGoogle Scholar
  34. 34.
    Montaye M, Ducimetière P, Ruidavets JB, Arveiler D, Dallongeville J, Bingham A, Ferrières J, Wagner A, Amouyel P (2006) Le gradient Nord-Sud de la morbidité et de la mortalité coronaires en France: données récentes des registres français des cardiopathies ischémiques, 1997–2002. Bulletin Epidémiologique Hebdomadaire 8–9:62–64Google Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Kénora Chau
    • 1
    • 2
    • 3
  • Nicolas Girerd
    • 2
    • 3
  • Martin Magnusson
    • 4
    • 5
  • Zohra Lamiral
    • 2
  • Erwan Bozec
    • 2
  • Ludovic Merckle
    • 2
  • Margret Leosdottir
    • 6
  • Erasmus Bachus
    • 7
  • Zied Frikha
    • 2
  • João Pedro Ferreira
    • 2
    • 3
  • Jean-Pierre Després
    • 8
    • 9
  • Patrick Rossignol
    • 2
    • 3
  • Jean-Marc Boivin
    • 1
    • 2
    • 3
  • Faiez Zannad
    • 2
    • 3
  1. 1.Département de Médecine GénéraleUniversité de LorraineVandoeuvre-lès-NancyFrance
  2. 2.INSERM, Centre d’Investigations Cliniques Plurithématique 1433, UMR 1116, Institut Lorrain du Cœur et des Vaisseaux Louis MathieuUniversité de Lorraine and CHU de NancyVandoeuvre-lès-NancyFrance
  3. 3.F-CRIN INI-CRCT Cardiovascular and Renal Clinical TrialistsNancyFrance
  4. 4.Department of Clinical SciencesLund UniversityMalmöSweden
  5. 5.Department of Cardiology, Skåne University HospitalLund UniversityMalmöSweden
  6. 6.Department of Ischemic Heart Disease, Skåne University HospitalLund UniversityMalmöSweden
  7. 7.Center of Emergency Medicine, Skåne University HospitalLund UniversityMalmöSweden
  8. 8.Centre de recherche de l’Institut universitaire de cardiologie et de pneumologie de QuébecQuebecCanada
  9. 9.Department of Kinesiology, Faculty of MedicineUniversité LavalQuebecCanada

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