{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T17:22:31Z","timestamp":1786987351968,"version":"build-2736575974"},"reference-count":55,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2020,6,16]]},"abstract":"\n Background<\/jats:title>\n Progressive cardiac remodeling and worsening myocardial function over time have been proposed as potential mediators of heart failure in obesity.<\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n We serially assessed cardiac structure and function in 254 subjects participating in a longitudinal study of obesity. Demographic, clinical, laboratory, and echocardiographic features were determined at baseline and 2\u2010, 6\u2010, and 11\u2010year follow\u2010up. We measured body mass index (\n BMI<\/jats:styled-content>\n ) exposure as the area under the curve of the\n BMI<\/jats:styled-content>\n at each of the 4 visits. At enrollment, mean age of the subjects was 47\u00a0years, 79% were women, mean\n BMI<\/jats:styled-content>\n was 44\u00a0kg\/m\n 2<\/jats:sup>\n , 26% had diabetes mellitus, 48% had hypertension, and 53% had hyperlipidemia. Between baseline and 11\u00a0years,\n BMI<\/jats:styled-content>\n increased by 1.1 and 0.3\u00a0kg\/m\n 2<\/jats:sup>\n in men and women, respectively. There were modest increases in left ventricular (\n LV<\/jats:styled-content>\n ) end\u2010diastolic volume,\n LV<\/jats:styled-content>\n mass, and left atrial volume, and significant decreases in early\/late mitral diastolic flow velocity ratio and E wave deceleration time. However, there were no significant changes in\n LV<\/jats:styled-content>\n ejection fraction or ratio of early mitral diastolic flow velocity\/early mitral annular velocity, whereas right ventricular fractional area change increased. Significant predictors of the change in\n LV<\/jats:styled-content>\n mass were male sex, baseline\n BMI<\/jats:styled-content>\n ,\n BMI<\/jats:styled-content>\n area under the curve, and change in\n LV<\/jats:styled-content>\n stroke volume, but not smoking, hypertension, or diabetes mellitus.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n In long\u2010standing, persistent severe obesity, there was evidence of cardiac remodeling over a period of 11\u00a0years, but no clear worsening of systolic or diastolic function. Measures of remodeling were most strongly related to\n BMI<\/jats:styled-content>\n . The observed changes might predispose to heart failure with preserved ejection fraction, but are not classic for an evolving dilated cardiomyopathy.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.119.014542","type":"journal-article","created":{"date-parts":[[2020,6,1]],"date-time":"2020-06-01T10:04:03Z","timestamp":1591005843000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":24,"title":["Longitudinal Changes in Cardiac Structure and Function in Severe Obesity: 11\u2010Year Follow\u2010Up in the Utah Obesity Study"],"prefix":"10.1161","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5887-8161","authenticated-orcid":false,"given":"Sheldon E.","family":"Litwin","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Medical University of South Carolina Charleston SC"},{"name":"Ralph H. 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