Comprehensive MRI analysis of early cardiac and vascular remodeling in middle-aged patients with abdominal obesity

Damien Mandry (1, 2) , Romain Eschalier (3, 4) , Anna Kearney-Schwartz (3, 5, 6, 4) , Patrick Rossignol (4, 3, 5) , Laure Joly (4, 5, 6) , Wassila Djaballah (1, 4, 7) , Philip Böhme (8) , Jean Escanyé (4, 7, 9) , Pierre-André Vuissoz (1, 4) , Renaud Fay (3) , Faïez Zannad (4, 3, 5, 10) , Pierre Marie (4, 3, 7)

1 IADI - Imagerie Adaptative Diagnostique et Interventionnelle
2 Département de Radiologie adultes [CHRU Nancy]
3 CIC-P - Centre d'investigation clinique plurithématique Pierre Drouin [Nancy]
4 UHP - Université Henri Poincaré - Nancy 1
5 BMCT - Bioingénierie Moléculaire, Cellulaire et Thérapeutique
6 Service de Gériatrie [CHRU Nancy]
7 Service de Médecine Nucléaire [CHRU Nancy]
8 Service d'Endocrinologie - Diabète - Nutrition [CHRU Nancy]
9 LMRMN - Laboratoire de Méthodologie en Résonance Magnétique Nucléaire
10 Service de Cardiologie [CHRU Nancy]

Objectives: To determine, using a comprehensive MRI investigation, prevalence and vascular correlates of early left-ventricular concentric remodeling in middle-aged patients with abdominal obesity. Left-ventricular and vascular remodeling are commonly associated with hypertension, but little is known for abdominal obesity patients, a population with definite increase in cardiovascular risk and high rates of further developments of hypertension and of the metabolic syndrome. Methods: Seventy middle-aged abdominal obesity patients (56 ± 5 years, 49% women, 69% with body mass index > 30 kg/m), who had no additional cardiovascular risk factor except for untreated stage 1 hypertension (16%), and 40 controls underwent MRI for detecting concentric remodeling (increase in left-ventricular mass/end-diastolic volume ratio) and identifying potential determinants, including arterial compliance indexes [aortic pulse wave velocity and total arterial compliance (TAC)] and total peripheral vascular resistances (TPVRs). Results: Twenty abdominal obesity patients (29%) had concentric remodeling (concentric remodeling+), whereas 50 did not (concentric remodeling-). Concentric remodeling+ patients were mostly men (85%), they frequently had stage 1 hypertension (45%) and few had left-ventricular hypertrophy (20%). When adjusted for sex, there was a step-by-step decline in TAC between controls (mean ± SEM: 2.10 ± 0.06 ml/mmHg), concentric remodeling- (1.82 ± 0.06 ml/mmHg) and concentric remodeling+ (1.42 ± 0.09 ml/mmHg, P < 0.005 for inter-group comparisons) and TPVRs were lower than controls for concentric remodeling- (14.7 ± 0.5 vs. 16.8 ± 0.5 ml/mmHg, P = 0.005) but not for concentric remodeling+ (17.5 ± 0.7 mmHg/min per l). Conclusions: Concentric remodeling is frequently documented by MRI in the middle-aged men with abdominal obesity and in association with a decrease in TAC no longer counter-balanced by a decrease in TPVR, suggesting a remodeling from proximal to peripheral vasculature.

Domaines: Imagerie; Cardiologie et système cardiovasculaire

Damien Mandry, Romain Eschalier, Anna Kearney-Schwartz, Patrick Rossignol, Laure Joly, et al.. Comprehensive MRI analysis of early cardiac and vascular remodeling in middle-aged patients with abdominal obesity. Journal of Hypertension, 2012, 30 (3), pp.567-573. ⟨10.1097/HJH.0b013e32834f6f3f⟩. ⟨hal-03179982⟩