The impact of visceral and general obesity on vascular and left ventricular function and geometry: a cross-sectional magnetic resonance imaging study of the UK Biobank

Aims: We aimed to evaluate the associations of body fat distribution with cardiovascular function and geometry in the middle-aged general population.

Methods and results: Four thousand five hundred and ninety participants of the UK Biobank (54% female, mean age 61.1 ± 7.2 years) underwent cardiac magnetic resonance for assessment of left ventricular (LV) parameters [end-diastolic volume (EDV), ejection fraction (EF), cardiac output (CO), and index (CI)] and magnetic resonance imaging for body composition analysis [subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT)]. Body fat percentage (BF%) was assessed by bioelectrical impedance. Linear regressions were performed to assess the impact of visceral (VAT) and general (SAT and BF%) obesity on cardiac function and geometry. Visceral obesity was associated with a smaller EDV [VAT: β -1.74 (-1.15 to -2.33)], lower EF [VAT: β -0.24 (-0.12 to -0.35), SAT: β 0.02 (-0.04 to 0.08), and BF%: β 0.02 (-0.02 to 0.06)] and the strongest negative association with CI [VAT: β -0.05 (-0.06 to -0.04), SAT: β -0.02 (-0.03 to -0.01), and BF% β -0.01 (-0.013 to -0.007)]. In contrast, general obesity was associated with a larger EDV [SAT: β 1.01 (0.72-1.30), BF%: β 0.37 (0.23-0.51)] and a higher CO [SAT: β 0.06 (0.05-0.07), BF%: β 0.02 (0.01-0.03)]. In the gender-specific analysis, only men had a significant association between VAT and EF [β -0.35 (-0.19 to -0.51)].

Conclusion: Visceral obesity was associated with a smaller LV EDV and subclinical lower LV systolic function in men, suggesting that visceral obesity might play a more important role compared to general obesity in LV remodelling.