Supplementary Material for: Differential Cardiac Remodeling in Overweight and Obesity: Insights from Noninvasive Imaging

Backgrounds
Weight gain is associated with cardiac abnormalities, but the differences in cardiac remodeling between overweight and obesity (O&O) remain unclear. This study explored the structural and functional cardiac changes associated with O&O using noninvasive imaging.
Methods
A retrospective study included participants from August 2021 to July 2023. Clinical data, laboratory results, and echocardiography reports were collected, and cardiac magnetic resonance (CMR) imaging underwent post-processing. Cardiac structural and functional parameters were compared among healthy weight, overweight, and obesity groups, and their relationships with body mass index (BMI) were analyzed.
Results
A total of 275 participants were included. Significant differences in left ventricular end-diastolic/systolic diameters, left atrial diameter, left ventricular ejection fraction (LVEF), and stroke volume (LVSV) index were observed between O&O and healthy weight groups (P<0.05). However, no significant differences were found between overweight and obesity groups for left ventricular septal (LVS) thickness, posterior wall (LVPW) thickness, cardiac index, or end-systolic volume index (P>0.05). Multivariable regression showed a positive correlation between BMI and cardiac structural/functional indicators (P<0.05), with greater changes in obesity. Loess spline analysis revealed that cardiac remodeling was more pronounced during the overweight stage.
Conclusions
Both O&O are associated with larger cardiac dimensions, increased myocardial mass, and impaired function. Cardiac remodeling accelerates during the overweight stage, emphasizing the need for early detection and intervention in overweight individuals to mitigate future health risks.

研究背景
体重增加与心脏异常存在关联，但超重与肥胖（Overweight and Obesity, O&O）之间的心脏重构差异仍不明确。本研究采用无创成像技术，探究了与O&O相关的心脏结构与功能变化。
研究方法
本研究为回顾性研究，纳入了2021年8月至2023年7月期间的受试者。收集了受试者的临床资料、实验室检测结果及超声心动图报告，并对心脏磁共振（Cardiac Magnetic Resonance, CMR）成像进行了后处理。对健康体重组、超重组与肥胖组的心脏结构与功能参数进行了比较，并分析了其与体质量指数（Body Mass Index, BMI）的相关性。
研究结果
最终共纳入275名受试者。O&O组与健康体重组在左心室舒张末期/收缩末期内径、左心房内径、左心室射血分数（Left Ventricular Ejection Fraction, LVEF）及每搏输出量指数（Stroke Volume Index, LVSV）方面均存在显著差异（P<0.05）。但超重组与肥胖组在左心室室间隔（Left Ventricular Septal, LVS）厚度、左心室后壁（Left Ventricular Posterior Wall, LVPW）厚度、心脏指数及收缩末期容积指数方面均无显著差异（P>0.05）。多变量回归分析显示，BMI与心脏结构/功能指标呈正相关（P<0.05），且肥胖组的变化更为显著。Loess样条分析结果显示，超重阶段的心脏重构更为突出。
研究结论
超重与肥胖（O&O）均与心脏尺寸增大、心肌质量增加及功能受损相关。超重阶段心脏重构进程加快，这提示需对超重人群开展早期筛查与干预，以降低其未来的健康风险。