Original ResearchMyocardial Tissue-Level Characteristics of Adults With Metabolically Healthy Obesity
Central Illustration
Section snippets
Study population
The EARLY-MYO-OBESITY (EARLY Assessment of MYOcardial Tissue Characteristics in OBESITY; NCT05277779) registry was a prospective, 3-center, cardiac imaging study that enrolled nondiabetic obese participants without cardiovascular disease. The study was approved by an institutional review committee at each participating center and was conducted in accordance with the Declaration of Helsinki. All participants provided written informed consent. A complete list of the inclusion and exclusion
Participant characteristics
Between January 2020 and May 2021, 121 nondiabetic individuals with obesity were enrolled in the EARLY-MYO-OBESITY registry. A total of 94 study participants were selected based on the eligibility criteria. After the exclusion of participants who refused CMR because of claustrophobia (n = 2) and those with inadequate CMR image quality (n = 4), a total of 88 nondiabetic individuals with obesity (mean age: 38 ± 11 years, 50% men) were included (Figure 1). There were 32 participants (36%) in the
Discussion
This study had 3 main findings. First, individuals with MHO had subclinical alterations in the myocardial tissue matrix, which was characterized by an increased ECV and native T2 value, indicating myocardial fibrosis and inflammatory edema. Second, myocardial tissue-level remodeling was correlated with subclinical LV systolic and diastolic dysfunction. Third, in nondiabetic individuals, increased BMI was independently associated with alteration of myocardial tissue characterization (Central
Conclusions
To the best of our knowledge, this is the first study to describe alteration of myocardial tissue characteristics in MHO. Our findings provide tissue-level evidence that MHO is not a benign condition, and suggest that myocardial fibrosis and inflammation are underlying mechanisms for the subclinical cardiac dysfunction observed in individuals with MHO. Our study provides insights into obesity-associated cardiac dysfunction and offers a rationale for aggressive strategies to prevent progression
Funding Support and Author Disclosures
This study received funding support from National Natural Science Foundation of China (U21A20341, 81971570, 81930007, 82202159, 31900821), Science and Technology Commission of Shanghai Municipality (21XD1432100, 22JC1402100, 22DZ2292400, 20Y11910500, 2022ZZ01008, 201409005200), Shanghai Hospital Development Center (SHDC2020CR2025B, SHDC12022102), Shanghai Municipal Health Commission (2022JC013, SHSLCZDZK06204), Shanghai Pudong New Area Health Commission (PW2019D-11), Shanghai Jiao Tong
Acknowledgments
The authors are indebted to the generous dedication to the EARLY-MYO-OBESITY registry by all coinvestigators as well as the support from Innovative Research Team of High-level Local Universities in Shanghai.
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Drs Zhao and Huang are joint first authors.