Heart failure & cardiomyopathiesResearch article
Body Mass Index, Left Ventricular Wall Stress, and NT-proBNP in Elderly Adults
- Atherosclerosis Risk in Communities study
- mediation analysis using the product of coefficients method
Authors' conclusion
Among older adults without HF, BMI positively associates with DWS, and DWS positively relates with NT-proBNP, which does not account for the net inverse relationship between BMI and NT-proBNP.
Study context
- Population
- Older adults without heart failure (HF) who underwent transthoracic echocardiographymedian 75 years, body mass index (BMI) 27.7 kg/m², 58% women, 18% Black
- Participants
- 4,444 adults
- Comparison
- BMI, left ventricular (LV) end-diastolic and end-systolic wall stress (DWS, SWS), and log-transformed NT-proBNP; mediation of the BMI–NT-proBNP association by wall stress (WS)
Main finding
Log-transformed NT-proBNP by BMI
β
−0.069 per 5 kg/m²
95% CI −0.096 to −0.042
As reported in the abstract
Further findings
| Outcome | Estimate |
|---|---|
| DWS by BMI · positive association | β 0.264 per 5 kg/m² (95% CI 0.073–0.453) |
| SWS by BMI · not associated | β −0.168 per 5 kg/m² (95% CI −0.708 to 0.403) |
| Log-transformed NT-proBNP by DWS and SWS — DWS · positive association | β 0.011 (95% CI 0.005–0.015) |
| Log-transformed NT-proBNP by DWS and SWS — SWS · positive association | β 0.004 (95% CI 0.002–0.006) |
| Mediation of BMI–NT-proBNP association — DWS · partially mediated | mediation effect 0.0028 (95% CI 0.0006–0.0055) |
| Mediation of BMI–NT-proBNP association — SWS · not mediated | mediation effect −0.0006 (95% CI −0.0032 to 0.0015) |
Original publication
Body Mass Index, Left Ventricular Wall Stress, and NT-proBNP in Elderly Adults. JACC Adv. Published 21 January 2026. doi:10.1016/j.jacadv.2025.102564
Summarised from the published abstract; every number is checked against it