Article

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 : 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.
CI - (c) The European Society of Cardiology 2014.

Langue : ANGLAIS