{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T09:23:18Z","timestamp":1775208198891,"version":"3.50.1"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"7","license":[{"start":{"date-parts":[[2021,3,17]],"date-time":"2021-03-17T00:00:00Z","timestamp":1615939200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,3,17]],"date-time":"2021-03-17T00:00:00Z","timestamp":1615939200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100000274","name":"British Heart Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000274","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005617","name":"BHF Centre of Research Excellence, Oxford","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005617","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100013373","name":"NIHR Oxford Biomedical Research Centre","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100013373","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int J Cardiovasc Imaging"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Obesity is associated with the development of left ventricular (LV) hypertrophy. Whether obesity in in the absence of comorbidities can cause LV hypertrophy to an extent which could create diagnostic uncertainty with pathological states (such as hypertrophic cardiomyopathy) is unknown. We used cine cardiovascular magnetic resonance imaging to precisely measure LV wall thickness in the septum and lateral wall in 764 people with body mass indices ranging from 18.5\u00a0kg\/m<jats:sup>2<\/jats:sup> to 59.2\u00a0kg\/m<jats:sup>2<\/jats:sup> in the absence of major comorbidities. Obesity was related to LV wall thickness across the cohort (basal septum r 0.30, P\u2009&lt;\u20090.001 and basal lateral wall r 0.18, P\u2009&lt;\u20090.001). Although no participant had hypertension, these associations remained highly significant after controlling for systolic blood pressure (all P\u2009&lt;\u20090.01). Each 10\u00a0kg\/m<jats:sup>2<\/jats:sup> increase in BMI was associated with an increase in basal septal wall thickness of 1.0\u00a0mm males and 0.8\u00a0mm in females, with no statistically significant difference between genders (P\u2009=\u20090.1). Even in class 3 obesity (BMI\u2009&gt;\u200940\u00a0kg\/m<jats:sup>2<\/jats:sup>), no LV wall thickness\u2009&gt;\u200913.4\u00a0mm in males or\u2009&gt;\u200912.7\u00a0mm in females was observed in this cohort. We confirm that obesity in the absence of comorbidities is associated with LV hypertrophy, and establish that the magnitude of this change is modest even in severe obesity. LV hypertrophy\u2009&gt;\u200914\u00a0mm cannot safely be attributed to obesity alone and alternative diagnoses should be considered.<\/jats:p>","DOI":"10.1007\/s10554-021-02207-1","type":"journal-article","created":{"date-parts":[[2021,3,17]],"date-time":"2021-03-17T14:02:46Z","timestamp":1615989766000},"page":"2277-2281","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Obesity in the absence of comorbidities is not related to clinically meaningful left ventricular hypertrophy"],"prefix":"10.1007","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3714-6711","authenticated-orcid":false,"given":"Andrew J. M.","family":"Lewis","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer J.","family":"Rayner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ines","family":"Abdesselam","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan","family":"Neubauer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oliver J.","family":"Rider","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,3,17]]},"reference":[{"issue":"5","key":"2207_CR1","doi-asserted-by":"publisher","first-page":"305","DOI":"10.1056\/NEJMoa020245","volume":"347","author":"S Kenchaiah","year":"2002","unstructured":"Kenchaiah S, Evans JC, Levy D et al (2002) Obesity and the risk of heart failure. N Engl J Med 347(5):305\u2013313","journal-title":"N Engl J Med"},{"issue":"2","key":"2207_CR2","doi-asserted-by":"publisher","first-page":"389","DOI":"10.1152\/physrev.00017.2007","volume":"88","author":"ED Abel","year":"2008","unstructured":"Abel ED, Litwin SE, Sweeney G (2008) Cardiac remodeling in obesity. Physiol Rev 88(2):389\u2013419","journal-title":"Physiol Rev"},{"issue":"1","key":"2207_CR3","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1016\/0002-9149(91)90718-Z","volume":"68","author":"S Chakko","year":"1991","unstructured":"Chakko S, Mayor M, Allison MD et al (1991) Abnormal left ventricular diastolic filling in eccentric left ventricular hypertrophy of obesity. Am J Cardiol 68(1):95\u201398","journal-title":"Am J Cardiol"},{"issue":"4","key":"2207_CR4","doi-asserted-by":"publisher","first-page":"292","DOI":"10.1093\/eurheartj\/ehs341","volume":"34","author":"OJ Rider","year":"2013","unstructured":"Rider OJ, Lewandowski A, Nethononda R et al (2013) Gender-specific differences in left ventricular remodelling in obesity: insights from cardiovascular magnetic resonance imaging. Eur Heart J 34(4):292\u2013299","journal-title":"Eur Heart J"},{"issue":"10","key":"2207_CR5","doi-asserted-by":"publisher","first-page":"1144","DOI":"10.1038\/ajh.2008.252","volume":"21","author":"AJ Woodiwiss","year":"2008","unstructured":"Woodiwiss AJ, Libhaber CD, Majane OH et al (2008) Obesity promotes left ventricular concentric rather than eccentric geometric remodeling and hypertrophy independent of blood pressure. Am J Hypertens 21(10):1144\u20131151","journal-title":"Am J Hypertens"},{"issue":"2","key":"2207_CR6","first-page":"139","volume":"2","author":"JE Hall","year":"2000","unstructured":"Hall JE (2000) Pathophysiology of obesity hypertension. CurrHypertens Rep 2(2):139\u2013147","journal-title":"CurrHypertens Rep"},{"issue":"6","key":"2207_CR7","first-page":"644","volume":"108","author":"S Sader","year":"2003","unstructured":"Sader S, Nian M, Liu P (2003) Leptin: a novel link between obesity, diabetes, cardiovascular risk, and ventricular hypertrophy. Am Heart Assoc 108(6):644\u2013646","journal-title":"Am Heart Assoc"},{"key":"2207_CR8","doi-asserted-by":"publisher","DOI":"10.1136\/heart.89.10.1127","volume-title":"Cardiac function and obesity","author":"R Vasan","year":"2003","unstructured":"Vasan R (2003) Cardiac function and obesity. BMJ Publishing Group Ltd, London"},{"issue":"39","key":"2207_CR9","doi-asserted-by":"publisher","first-page":"2733","DOI":"10.1093\/eurheartj\/ehu284","volume":"35","author":"PM Elliott","year":"2014","unstructured":"Members ATF, Elliott PM, Anastasakis A et al (2014) 2014 ESC guidelines on diagnosis and management of hypertrophic cardiomyopathy: the task force for the diagnosis and management of hypertrophic cardiomyopathy of the European society of cardiology (ESC). Eur Heart J 35(39):2733\u20132779","journal-title":"Eur Heart J"},{"issue":"25","key":"2207_CR10","doi-asserted-by":"publisher","first-page":"e159","DOI":"10.1016\/j.jacc.2020.08.045","volume":"76","author":"SR Ommen","year":"2020","unstructured":"Ommen SR, Mital S, Burke MA et al (2020) 2020 AHA\/ACC guideline for the diagnosis and treatment of patients with hypertrophic cardiomyopathy: a report of the American College of Cardiology\/American Heart Association joint committee on clinical practice guidelines. J Am CollCardiol 76(25):e159\u2013e240","journal-title":"J Am CollCardiol"},{"issue":"3","key":"2207_CR11","doi-asserted-by":"publisher","first-page":"350","DOI":"10.1093\/ejechocard\/jep017","volume":"10","author":"J Rawlins","year":"2009","unstructured":"Rawlins J, Bhan A, Sharma S (2009) Left ventricular hypertrophy in athletes. Eur J Echocardiogr 10(3):350\u2013356","journal-title":"Eur J Echocardiogr"},{"issue":"5","key":"2207_CR12","doi-asserted-by":"publisher","first-page":"726","DOI":"10.1016\/j.amjcard.2013.04.053","volume":"112","author":"MA Allison","year":"2013","unstructured":"Allison MA, Bluemke DA, McClelland R et al (2013) Relation of leptin to left ventricular hypertrophy (from the multi-ethnic study of atherosclerosis). Am J Cardiol 112(5):726\u2013730","journal-title":"Am J Cardiol"},{"issue":"5","key":"2207_CR13","doi-asserted-by":"publisher","first-page":"631","DOI":"10.1007\/s10741-012-9337-8","volume":"18","author":"M Park","year":"2013","unstructured":"Park M, Sweeney G (2013) Direct effects of adipokines on the heart: focus on adiponectin. Heart Fail Rev 18(5):631\u2013644","journal-title":"Heart Fail Rev"},{"issue":"4","key":"2207_CR14","first-page":"28","volume":"17","author":"AJ Woodiwiss","year":"2015","unstructured":"Woodiwiss AJ, Norton GR (2015) Obesity and left ventricular hypertrophy: the hypertension connection. CurrHypertens Rep 17(4):28","journal-title":"CurrHypertens Rep"},{"issue":"8","key":"2207_CR15","doi-asserted-by":"publisher","first-page":"718","DOI":"10.1016\/j.jacc.2009.02.086","volume":"54","author":"OJ Rider","year":"2009","unstructured":"Rider OJ, Francis JM, Ali MK et al (2009) Beneficial cardiovascular effects of bariatric surgical and dietary weight loss in obesity. J Am CollCardiol 54(8):718\u2013726","journal-title":"J Am CollCardiol"},{"issue":"27","key":"2207_CR16","doi-asserted-by":"publisher","first-page":"2129","DOI":"10.1093\/eurheartj\/ehw128","volume":"37","author":"P Ponikowski","year":"2016","unstructured":"Ponikowski P, Voors AA, Anker SD et al (2016) 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: the task force for the diagnosis and treatment of acute and chronic heart failure of the European society of cardiology (ESC) developed with the special contribution of the heart failure association (HFA) of the ESC. Eur Heart J 37(27):2129\u20132200","journal-title":"Eur Heart J"},{"issue":"8","key":"2207_CR17","doi-asserted-by":"publisher","first-page":"679","DOI":"10.1111\/obr.12292","volume":"16","author":"J Rayner","year":"2015","unstructured":"Rayner J, Neubauer S, Rider O (2015) The paradox of obesity cardiomyopathy and the potential for weight loss as a therapy. Obes Rev 16(8):679\u2013690","journal-title":"Obes Rev"},{"issue":"2","key":"2207_CR18","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1016\/j.jchf.2013.01.006","volume":"1","author":"CJ Lavie","year":"2013","unstructured":"Lavie CJ, Alpert MA, Arena R et al (2013) Impact of obesity and the obesity paradox on prevalence and prognosis in heart failure. JACC Heart Fail 1(2):93\u2013102","journal-title":"JACC Heart Fail"},{"issue":"5","key":"2207_CR19","doi-asserted-by":"publisher","first-page":"449","DOI":"10.1016\/j.jacc.2013.03.062","volume":"62","author":"I Olivotto","year":"2013","unstructured":"Olivotto I, Maron BJ, Tomberli B et al (2013) Obesity and its association to phenotype and clinical course in hypertrophic cardiomyopathy. J Am CollCardiol 62(5):449\u2013457","journal-title":"J Am CollCardiol"}],"container-title":["The International Journal of Cardiovascular Imaging"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10554-021-02207-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10554-021-02207-1\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10554-021-02207-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,7,18]],"date-time":"2021-07-18T16:11:12Z","timestamp":1626624672000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10554-021-02207-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,17]]},"references-count":19,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2021,7]]}},"alternative-id":["2207"],"URL":"https:\/\/doi.org\/10.1007\/s10554-021-02207-1","relation":{},"ISSN":["1569-5794","1573-0743"],"issn-type":[{"value":"1569-5794","type":"print"},{"value":"1573-0743","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,17]]},"assertion":[{"value":"12 January 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 February 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 March 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors have no relevant conflict of interest to disclose.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}