Vol 5, No 3 (2020)
Original article
Published online: 2020-09-07

open access

Page views 431
Article views/downloads 725
Get Citation

Connect on Social Media

Connect on Social Media

Relation between parameters of body composition and echocardiography in patients with nonvalvular atrial fibrillation

Marzena Anaszewicz1, Jacek Budzyński23
Medical Research Journal 2020;5(3):167-176.

Abstract

Purpose: Both nutritional status and echocardiographic parameters are associated with the risk of atrial fibrillation (AF). The aim of this study was to determine the relationships between parameters of transthoracic echocardiography and nutritional status assessment as risk factors for AF.

Methods:
This cross-sectional study considered 120 consecutive patients hospitalized due to AF and 240 inpatients admitted due to exacerbation of cardiovascular conditions. Echocardiographic parameters and parameters of nutritional status were determined for each patient.

Results:
Patients in the lowest body mass index (BMI) quartile and without visceral adiposity had the lowest standard echocardiographic parameters; however, the majority of these differences disappeared after the parameters were indexed to BSA. In logistic regression analysis, echocardiographic parameters were associated with slightly higher or similar AF risk comparing with parameters of nutritional status assessment. When the comparison was made in relation to cut-off values obtained in ROC analysis, then having a visceral adipose tissue (VAT) score ≥ 12 was associated with a lower increase in AF risk (odds ratio [OR]; 95% confidence interval [CI]: 3.09; 1.85–5.15) than the risk increase associated with e.g. left atrium diameter greater than 45mm ([OR; 95% CI] 10.483; 6.308–17.421).

Conclusions:
The unitary values of echocardiographic and body composition parameters only slightly differed in relation to the risk of AF occurrence, however, the use of cut-off values significantly increases an impact of echocardiography on the prediction of AF. The U-shaped relationships between a patient’s nutritional status and AF occurrence cannot be explained by the effect of body mass on cardiac structure and size.

Article available in PDF format

View PDF Download PDF file

References

  1. Anaszewicz M, Budzyński J. Clinical significance of nutritional status in patients with atrial fibrillation: An overview of current evidence. J Cardiol. 2017; 69(5): 719–730.
  2. Budzyński J, Anaszewicz M. The associations between atrial fibrillation and parameters of nutritional status assessment in the general hospital population - a cross-sectional analysis of medical documentation. Kardiol Pol. 2017; 75(3): 231–239.
  3. Pathak RK, Middeldorp ME, Lau DH, et al. Aggressive risk factor reduction study for atrial fibrillation and implications for the outcome of ablation: the ARREST-AF cohort study. J Am Coll Cardiol. 2014; 64(21): 2222–2231.
  4. Pathak RK, Elliott A, Middeldorp ME, et al. Impact of CARDIOrespiratory FITness on Arrhythmia Recurrence in Obese Individuals With Atrial Fibrillation: The CARDIO-FIT Study. J Am Coll Cardiol. 2015; 66(9): 985–996.
  5. Huang G, Parikh PB, Malhotra A, et al. Relation of Body Mass Index and Gender to Left Atrial Size and Atrial Fibrillation. Am J Cardiol. 2017; 120(2): 218–222.
  6. Bello NA, Cheng S, Claggett B, et al. Association of Weight and Body Composition on Cardiac Structure and Function in the ARIC Study (Atherosclerosis Risk in Communities). Circ Heart Fail. 2016; 9(8).
  7. Markus MR, Werner N, Schipf S, et al. Changes in Body Weight and Composition Are Associated With Changes in Left Ventricular Geometry and Function in the General Population: SHIP (Study of Health in Pomerania). Circ Cardiovasc Imaging. 2017; 10(3): e005544.
  8. Lee SC, Daimon M, Di Tullio MR, et al. Beneficial effect of body weight control on left ventricular diastolic function in the general population: an analysis of longitudinal data from a health check-up clinic. Eur Heart J Cardiovasc Imaging. 2018; 19(2): 136–142.
  9. Le Jemtel TH, Samson R, Jaiswal A, et al. Regression of Left Ventricular Mass After Bariatric Surgery. Curr Hypertens Rep. 2017; 19(9): 68.
  10. Psychari SN, Tsoukalas D, Varvarousis D, et al. Opposite relations of epicardial adipose tissue to left atrial size in paroxysmal and permanent atrial fibrillation. SAGE Open Med. 2018; 6: 2050312118799908.
  11. von Jeinsen B, Short MI, Xanthakis V, et al. Association of Circulating Adipokines With Echocardiographic Measures of Cardiac Structure and Function in a Community-Based Cohort. J Am Heart Assoc. 2018; 7(13).
  12. Cescau A, Van Aelst LNL, Baudet M, et al. High body mass index is a predictor of left ventricular reverse remodelling in heart failure with reduced ejection fraction. ESC Heart Fail. 2017; 4(4): 686–689.
  13. Zhang C, Deng Y, Liu Y, et al. Preclinical cardiovascular changes in children with obesity: A real-time 3-dimensional speckle tracking imaging study. PLoS One. 2018; 13(10): e0205177.
  14. Ashwell M, Gunn P, Gibson S. Waist-to-height ratio is a better screening tool than waist circumference and BMI for adult cardiometabolic risk factors: systematic review and meta-analysis. Obes Rev. 2012; 13(3): 275–286.
  15. Shen S, Lu Y, Qi H, et al. Waist-to-height ratio is an effective indicator for comprehensive cardiovascular health. Sci Rep. 2017; 7: 43046.
  16. Mornar Jelavić M, Babić Z, Pintarić H, et al. The Role of Anthropometry in Acute St-Elevation Myocardial Infarction Treated with Primary Percutaneous Coronary Intervention. Acta Clin Croat. 2016; 55(2): 224–232.
  17. Piepoli MF, Hoes AW, Agewall S, et al. Authors/Task Force Members:, Authors/Task Force Members, Additional Contributor: Simone Binno (Italy), Document Reviewers:, ESC Scientific Document Group. 2016 European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts)Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur Heart J. 2016; 37(29): 2315–2381.
  18. Mancusi C, Gerdts E, Losi MA, et al. Differential effect of obesity on prevalence of cardiac and carotid target organ damage in hypertension (the Campania Salute Network). Int J Cardiol. 2017; 244: 260–264.
  19. Dibeklioglu SE, Çevik BŞ, Acar B, et al. The association between obesity, hypertension and left ventricular mass in adolescents. J Pediatr Endocrinol Metab. 2017; 30(2): 167–174.
  20. Kurisu S, Ikenaga H, Watanabe N, et al. Implications of World Health Organization classification for body mass index on the correlations between common electrocardiographic indexes for left ventricular hypertrophy and left ventricular mass. Clin Exp Hypertens. 2016; 38(8): 715–720.
  21. Yoon HE, Choi SSu, Kim Y, et al. The Clinical Usefulness of Measurement of Visceral Fat Area Using Multi-Frequency Bioimpedance: The Association with Cardiac and Renal Function In General Population with Relatively Normal Renal Function. Int J Med Sci. 2017; 14(13): 1375–1381.
  22. Chau K, Girerd N, Magnusson M, et al. Obesity and metabolic features associated with long-term developing diastolic dysfunction in an initially healthy population-based cohort. Clin Res Cardiol. 2018; 107(10): 887–896.
  23. Tugcu A, Russo C, Jin Z, et al. Association of body size metrics with left atrial phasic volumes and reservoir function in the elderly. Eur Heart J Cardiovasc Imaging. 2018; 19(10): 1157–1164.
  24. Son JW, Sung JK, Lee JW, et al. Abdominal obesity and structure and function of the heart in healthy male Koreans: The ARIRANG study. Medicine (Baltimore). 2016; 95(39): e4930.
  25. Şeker T, Türkoğlu C, Harbalıoğlu H, et al. Epicardial Fat Thickness is Associated with Abnormal Left Ventricle Geometry in Newly Diagnosed Hypertension. Acta Cardiol Sin. 2018; 34(3): 280–287.
  26. Bairapareddy KC, Maiya AG, Kumar P, et al. Effect of aerobic exercise on echocardiographic epicardial adipose tissue thickness in overweight individuals. Diabetes Metab Syndr Obes. 2018; 11: 303–312.
  27. Kirchhof P, Benussi S, Kotecha D, et al. ESC Scientific Document Group. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J. 2016; 37(38): 2893–2962.
  28. Winkle RA, Mead RH, Engel G, et al. Impact of obesity on atrial fibrillation ablation: Patient characteristics, long-term outcomes, and complications. Heart Rhythm. 2017; 14(6): 819–827.