Association of PREVENT risk model with body fat distribution and subclinical left ventricular dysfunction

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Background Recently developed Predicting Risk of cardiovascular disease EVENTs (PREVENT) risk model has shown excellent performance for cardiovascular risk stratification, but its relationship with body fat distribution and left ventricular (LV) mechanics is unknown. Methods We investigated 517 participants free of overt cardiac disease who underwent an extensive cardiovascular health examination. The PREVENT risk score was calculated in each participant, and the study population was categorized into three groups based on the tertiles of the risk score. Body fat distribution was assessed using computed tomography and quantitatively assessed as visceral fat area (VFA) and subcutaneous fat area (SFA) at the level of the umbilicus. All participants also underwent two-dimensional transthoracic echocardiography, and LV global longitudinal strain (LVGLS) was obtained with speckle-tracking analysis. Univariable and multivariable logistic regression models were constructed to investigate the association between the PREVENT risk model and abnormal LVGLS (<17.0% for male and <18.0% for female) adjusting for the clinically relevant covariates. Results Individuals with high PREVENT score had the largest VFA (160.0 [109.7-194.4] cm 2 ), followed by intermediate and low score groups (138.6 [92.0-176.4] cm 2 and 89.4 [50.6-123.9] cm 2 , p<0.001), while SFA was comparable among the three groups (p=0.480). LVGLS was significantly lower with increasing PREVENT risk score (20.4±3.3% vs. 18.9±2.8% vs. 18.1±2.7%, p<0.001). Multivariable logistic regression analysis showed that the PREVENT risk score carried an independent risk for abnormal LVGLS (adjusted odds ratio per 1% increase 1.06, p=0.006). Conclusion The PREVENT risk model was associated with abdominal visceral fat accumulation and subclinical LV dysfunction.

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