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. 2025 May 9:11:e10.
doi: 10.15420/cfr.2024.26. eCollection 2025.

Obesity Phenotypes Causally Affect Cardiac MRI Structure and Induced Non-ischaemic Cardiomyopathy

Long Peng  1 , Tao Zeng  2 , Enxi Quan  3 , Shufang Pan  2 , Bin Li  2 , Zheqi Wen  1 , Zhaojun Xiong  1 , Yunyue Zhao  1
Affiliations

Obesity Phenotypes Causally Affect Cardiac MRI Structure and Induced Non-ischaemic Cardiomyopathy

Long Peng et al. Card Fail Rev. .

Abstract

Background: The growing obesity epidemic highlights the need to understand how various obesity phenotypes affect myocardial structure and increase non-ischaemic cardiomyopathy (NICM) incidence. The aim of this study was to investigate the causal effect of eight obesity-related traits on NICM and 16 cardiac MRI parameters. Potential mediators between obesity and NICM were also investigated.

Methods: Two-sample Mendelian randomisation was used to explore the causal relationship between eight obesity-related traits and NICM and assess their impact on cardiac MRI indicators. The study also used validation dataset analysis and multivariable Mendelian randomisation to ensure robustness, and mediation Mendelian randomisation analysis to identify metabolic markers as potential mediators.

Results: All eight obesity-related traits demonstrated a causal relationship with NICM, with the relationship between BMI and NICM persisting after adjustment for LDL cholesterol, urate level and hypertension (HTN). These traits also influenced arterial and cardiac structure and function, especially with regard to left ventricular mass. HTN was identified as a significant mediator, with a mediation effect ratio of 31%.

Conclusion: There is a robust causal association between obesity and NICM, and with abnormalities in myocardial structure and function. HTN emerges as a pivotal mediator in the obesity-NICM pathway, underscoring the critical role of managing obesity and HTN in preventing NICM progression.

Keywords: Mendelian randomisation; Obesity; body mass index; hypertension; non-ischaemic cardiomyopathy.

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Conflict of interest statement

Disclosure: The authors have no conflicts of interest to declare.

Figures

Figure 1:
Figure 1:. Study Design
Figure 2:
Figure 2:. Genetically Predicted Obesity-related Traits: Association with Risk of Non-ischaemic Cardiomyopathy
Figure 3:
Figure 3:. Genetically Predicted Obesity-related Traits: Association with 16 Cardiac MRI Indicators
Figure 4:
Figure 4:. Genetically Predicted Association of Eight Obesity-related Traits: Association with Risk of LVIDd and LVM
Figure 5:
Figure 5:. Figure 5: Multivariable Mendelian Randomisation and Mediation Analysis for BMI and Non-ischaemic Cardiomyopathy
See this image and copyright information in PMC

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