Regional Adiposity and Risk of Heart Failure and Mortality: The Jackson Heart Study

Vishal N Rao, Christopher G Bush, Morgana Mongraw-Chaffin, Michael E Hall, Donald Clark 3rd, Marat Fudim, Adolfo Correa, Bradley G Hammill, Emily O'Brien, Yuan-I Min, Robert J Mentz, Vishal N Rao, Christopher G Bush, Morgana Mongraw-Chaffin, Michael E Hall, Donald Clark 3rd, Marat Fudim, Adolfo Correa, Bradley G Hammill, Emily O'Brien, Yuan-I Min, Robert J Mentz

Abstract

Background Visceral adipose tissue (VAT) is associated with incident heart failure (HF) and HF with preserved ejection fraction, yet it is unknown how pericardial and abdominal adiposity affect HF and mortality risks in Black individuals. We examined the associations of pericardial adipose tissue (PAT), VAT, and subcutaneous adipose tissue (SAT) with incident HF hospitalization and all-cause mortality in a large community cohort of Black participants. Methods and Results Among the 2882 Jackson Heart Study Exam 2 participants without prevalent HF who underwent body computed tomography, we used Cox proportional hazards models to examine associations between computed tomography-derived regional adiposity and incident HF hospitalization and all-cause mortality. Fully adjusted models included demographics and cardiovascular disease risk factors. Median follow-up was 10.6 years among participants with available VAT (n=2844), SAT (n=2843), and PAT (n=1386). Fully adjusted hazard ratios (95% CIs) of distinct computed tomography-derived adiposity measures (PAT per 10 cm3, VAT or SAT per 100 cm3) were as follows: for incident HF, PAT 1.08 (95% CI, 1.02-1.14) and VAT 1.04 (95% CI, 1.01-1.08); for HF with preserved ejection fraction, PAT 1.13 (95% CI, 1.04-1.21) and VAT 1.07 (95% CI, 1.01-1.13); for mortality, PAT 1.07 (95% CI, 1.03-1.12) and VAT 1.01 (95% CI, 0.98-1.04). SAT was not associated with either outcome. Conclusions High PAT and VAT, but not SAT, were associated with incident HF and HF with preserved ejection fraction, and only PAT was associated with mortality in the fully adjusted models in a longitudinal community cohort of Black participants. Future studies may help understand whether changes in regional adiposity improves HF, particularly HF with preserved ejection fraction, risk predictions. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT00005485.

Keywords: Black participants; Jackson Heart Study; heart failure; mortality; obesity; regional adiposity.

Conflict of interest statement

None.

Figures

Figure 1. Cumulative incidence of heart failure…
Figure 1. Cumulative incidence of heart failure and all‐cause mortality by regional adiposity quartiles in the Jackson Heart Study.
Incident heart failure and all‐cause mortality increased in the highest PAT (A and B) and VAT (C and D) quartiles when compared with the lowest quartile. There was no association between the SAT quartiles and incident heart failure (E). All‐cause mortality decreased with the higher SAT quartiles (F). PAT indicates pericardial adipose tissue volume; Q1, quartile 1; Q2, quartile 2; Q3, quartile 3; Q4, quartile 4; SAT, subcutaneous adipose tissue; and VAT, visceral adipose tissue volume.

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