{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T04:07:22Z","timestamp":1790482042086,"version":"4.1.0"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Imaging"],"published-print":{"date-parts":[[2016,6]]},"abstract":"<jats:sec>\n            <jats:title>Background\u2014<\/jats:title>\n            <jats:p>Central obesity, defined by increased waist circumference or waist:hip ratio (WHR), is associated with increased cardiovascular events, including heart failure. However, the pathophysiological link between central obesity and adverse cardiovascular outcomes remains poorly understood. We hypothesized that central obesity and larger WHR are independently associated with worse cardiac mechanics (reduced left ventricular strain and systolic [s\u2032] and early diastolic [e\u2032] tissue velocities).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Results\u2014<\/jats:title>\n            <jats:p>\n              We performed speckle-tracking analysis of echocardiograms from participants in the Hypertension Genetic Epidemiology Network (HyperGEN) study, a population- and family-based epidemiological study (n=2181). Multiple indices of systolic and diastolic cardiac mechanics were measured. We evaluated the association between central obesity and cardiac mechanics using multivariable-adjusted linear mixed-effects models to account for relatedness among participants. The mean age of the cohort was 51\u00b114 years, 58% were women, and 47% were black. Mean body mass index was 30.8\u00b17.1 kg\/m\n              <jats:sup>2<\/jats:sup>\n              , waist circumference was 102\u00b117 cm, WHR was 0.91\u00b10.08, and 80% had central obesity based on waist circumference and WHR criteria. After adjusting for multiple potential confounders (including age, sex, race, physical activity, body mass index, heart rate, smoking status, systolic blood pressure, fasting glucose, total cholesterol, antihypertensive medication use, glomerular filtration rate, left ventricular mass index, wall motion abnormalities, and ejection fraction), central obesity and WHR remained associated with worse global longitudinal strain, early diastolic strain rate, s\u2032 velocity, and e\u2032 velocity (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.05 for all comparisons). There were no significant statistical interactions between WHR and obesity status.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>In this cross-sectional study of participants with multiple comorbidities, central obesity was found to be associated with adverse cardiac mechanics.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circimaging.115.004396","type":"journal-article","created":{"date-parts":[[2016,6,16]],"date-time":"2016-06-16T06:04:55Z","timestamp":1466057095000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":83,"title":["Association of Central Adiposity With Adverse Cardiac Mechanics"],"prefix":"10.1161","volume":"9","author":[{"given":"Senthil","family":"Selvaraj","sequence":"first","affiliation":[{"name":"From the Division of Cardiology, Department of Medicine (S.S., E.E.M., F.G.A., S.J.S.) and the Department of Preventive Medicine (K.-Y.A.K., J.P.), Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Epidemiology, School of Public Health, University of Alabama Birmingham (J.S., M.R.I., C.E.L., D.K.A.); the Department of Genetic Medicine, Weill Cornell Medical College in Qatar, Doha, (S.C.H.); and the Department of Medicine, University of Utah, Salt Lake City (S.C.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva E.","family":"Martinez","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Department of Medicine (S.S., E.E.M., F.G.A., S.J.S.) and the Department of Preventive Medicine (K.-Y.A.K., J.P.), Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Epidemiology, School of Public Health, University of Alabama Birmingham (J.S., M.R.I., C.E.L., D.K.A.); the Department of Genetic Medicine, Weill Cornell Medical College in Qatar, Doha, (S.C.H.); and the Department of Medicine, University of Utah, Salt Lake City (S.C.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank G.","family":"Aguilar","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Department of Medicine (S.S., E.E.M., F.G.A., S.J.S.) and the Department of Preventive Medicine (K.-Y.A.K., J.P.), Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Epidemiology, School of Public Health, University of Alabama Birmingham (J.S., M.R.I., C.E.L., D.K.A.); the Department of Genetic Medicine, Weill Cornell Medical College in Qatar, Doha, (S.C.H.); and the Department of Medicine, University of Utah, Salt Lake City (S.C.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kwang-Youn A.","family":"Kim","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Department of Medicine (S.S., E.E.M., F.G.A., S.J.S.) and the Department of Preventive Medicine (K.-Y.A.K., J.P.), Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Epidemiology, School of Public Health, University of Alabama Birmingham (J.S., M.R.I., C.E.L., D.K.A.); the Department of Genetic Medicine, Weill Cornell Medical College in Qatar, Doha, (S.C.H.); and the Department of Medicine, University of Utah, Salt Lake City (S.C.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Peng","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Department of Medicine (S.S., E.E.M., F.G.A., S.J.S.) and the Department of Preventive Medicine (K.-Y.A.K., J.P.), Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Epidemiology, School of Public Health, University of Alabama Birmingham (J.S., M.R.I., C.E.L., D.K.A.); the Department of Genetic Medicine, Weill Cornell Medical College in Qatar, Doha, (S.C.H.); and the Department of Medicine, University of Utah, Salt Lake City (S.C.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin","family":"Sha","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Department of Medicine (S.S., E.E.M., F.G.A., S.J.S.) and the Department of Preventive Medicine (K.-Y.A.K., J.P.), Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Epidemiology, School of Public Health, University of Alabama Birmingham (J.S., M.R.I., C.E.L., D.K.A.); the Department of Genetic Medicine, Weill Cornell Medical College in Qatar, Doha, (S.C.H.); and the Department of Medicine, University of Utah, Salt Lake City (S.C.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marguerite R.","family":"Irvin","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Department of Medicine (S.S., E.E.M., F.G.A., S.J.S.) and the Department of Preventive Medicine (K.-Y.A.K., J.P.), Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Epidemiology, School of Public Health, University of Alabama Birmingham (J.S., M.R.I., C.E.L., D.K.A.); the Department of Genetic Medicine, Weill Cornell Medical College in Qatar, Doha, (S.C.H.); and the Department of Medicine, University of Utah, Salt Lake City (S.C.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cora E.","family":"Lewis","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Department of Medicine (S.S., E.E.M., F.G.A., S.J.S.) and the Department of Preventive Medicine (K.-Y.A.K., J.P.), Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Epidemiology, School of Public Health, University of Alabama Birmingham (J.S., M.R.I., C.E.L., D.K.A.); the Department of Genetic Medicine, Weill Cornell Medical College in Qatar, Doha, (S.C.H.); and the Department of Medicine, University of Utah, Salt Lake City (S.C.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven C.","family":"Hunt","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Department of Medicine (S.S., E.E.M., F.G.A., S.J.S.) and the Department of Preventive Medicine (K.-Y.A.K., J.P.), Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Epidemiology, School of Public Health, University of Alabama Birmingham (J.S., M.R.I., C.E.L., D.K.A.); the Department of Genetic Medicine, Weill Cornell Medical College in Qatar, Doha, (S.C.H.); and the Department of Medicine, University of Utah, Salt Lake City (S.C.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donna K.","family":"Arnett","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Department of Medicine (S.S., E.E.M., F.G.A., S.J.S.) and the Department of Preventive Medicine (K.-Y.A.K., J.P.), Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Epidemiology, School of Public Health, University of Alabama Birmingham (J.S., M.R.I., C.E.L., D.K.A.); the Department of Genetic Medicine, Weill Cornell Medical College in Qatar, Doha, (S.C.H.); and the Department of Medicine, University of Utah, Salt Lake City (S.C.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjiv J.","family":"Shah","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Department of Medicine (S.S., E.E.M., F.G.A., S.J.S.) and the Department of Preventive Medicine (K.-Y.A.K., J.P.), Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Epidemiology, School of Public Health, University of Alabama Birmingham (J.S., M.R.I., C.E.L., D.K.A.); the Department of Genetic Medicine, Weill Cornell Medical College in Qatar, Doha, (S.C.H.); and the Department of Medicine, University of Utah, Salt Lake City (S.C.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2009.2014"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2008.06.018"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.107.739714"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.112.000086"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1152\/physrev.1994.74.4.761"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1467-789X.2009.00623.x"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/fampra\/cmp048"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/ATVBAHA.107.159228"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1152\/ajpheart.00642.2013"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1047-2797(00)00063-6"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/81.4.757"},{"key":"e_1_3_3_13_2","volume-title":"Waist Circumference and Waist-Hip Ratio, Report of a WHO Expert Consultation","author":"World Health Organization","year":"2011","unstructured":"World Health Organization. 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