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Abdominal Fat, Not BMI, Linked to Harmful Heart Remodeling in MRI Study

Cardiac MRI of 2,244 adults tied high waist-to-hip ratio to concentric hypertrophy independent of traditional risk factors.

Overview

  • Researchers analyzed cardiac MRI scans from 2,244 Hamburg City Health Study participants aged 46–78 without diagnosed cardiovascular disease.
  • Higher waist-to-hip ratio was associated with concentric hypertrophy—thicker myocardium with smaller chamber volumes—whereas BMI more often tracked with enlarged chambers.
  • Effects were stronger in men, particularly in the right ventricle, and included subtle tissue changes detectable only with advanced MRI.
  • These were independent associations after adjustment for hypertension, smoking, diabetes and cholesterol, reflecting risk that BMI alone can miss.
  • Waist-to-hip ratio classified more people as obese than BMI (91% of men and 64% of women vs 69% and 56%), prompting calls for routine WHR measurement and targeting abdominal fat; findings were presented at the RSNA meeting.