The Burden of a Heavy Heart

• Published in: Clinical chemistry (Baltimore, Md.) Vol. 64; no. 1; pp. 10 - 12
• Main Authors: Srivastava, Pratyaksh K, Everett, Brendan M
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01-01-2018
• Subjects: Body mass index; Cardiovascular disease; Cardiovascular diseases; Gastrointestinal surgery; Health risk assessment; Heart; Myocardial infarction; Myocardium; Obesity
• ISSN: 0009-9147; 1530-8561
• DOI: 10.1373/clinchem.2017.282970

The independent contribution of obesity to CVD risk, and the ways in which changes in weight and obesity status might alter this contribution, remains poorly understood. Because high-sensitivity assays for cardiac troponin can detect even small amounts of myocardial injury, they may serve as useful tools to help elucidate the effects of obesity on the myocardium. In the Framingham Heart Study, obese individuals had double the risk of incident heart failure, and a recent metaanalysis of 23 prospective studies found that each 5-unit increase in body mass index (BMI) was associated with a 41% increase in the risk of heart failure incidence (relative risk, 1.41; 95% CI, 1.34-1.47) (2, 3). In the Atherosclerosis Risk in Communities cohort, investigators reported that compared with those with undetectable concentrations of hs-cTnT, those with an abnormal hs-cTnT (>14 ng/L) were at markedly increased risk of heart failure hospitalization (hazard ratio, 6.0; 95% CI, 4.5-7.9) and fatal coronary heart disease or myocardial infarction (hazard ratio, 2.8; 95% CI, 2.1-3.9) (6). By contrast, deFilippi and colleagues reported observational evidence from the Cardiovascular Health Study that regular physical activity was associated with slower age-related increases in cardiac troponin and reductions in the risk of heart failure (11).