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(Circulation. 2001;103:820.)
© 2001 American Heart Association, Inc.

Clinical Investigation and Reports

Relations of Stroke Volume and Cardiac Output to Body Composition

The Strong Heart Study

Tarquin Collis, MD; Richard B. Devereux, MD; Mary J. Roman, MD; Giovanii de Simone, MD; Jeun-Liang Yeh, PhD; Barbara V. Howard, PhD; Richard R. Fabsitz, MA; Thomas K. Welty, MD

From Cornell Medical Center, New York, NY (T.C., R.B.D., M.J.R., G.d.S.); University of Oklahoma Health Sciences Center, Oklahoma City (J.-L.Y.); MedStar Research Institute, Washington, DC (B.V.H.); National Heart, Lung, and Blood Institute, Bethesda, Md (R.R.F.); and Aberdeen Area Tribal Chairmen’s Health Board, Rapid City, SD (T.K.W.).

Correspondence to Richard B. Devereux, MD, Division of Cardiology, Box 222, Cornell Medical Center, 525 E 68th St, New York, NY 10021. E-mail rbdevere{at}med.cornell.edu

Background—Although cardiac output (CO) plays the vital role of delivering nutrients to body tissues, few data are available concerning the relations of stroke volume (SV) and CO to body composition in large population samples.

Methods and Results—Doppler and 2D echocardiography and bioelectric impedance in 2744 Strong Heart Study participants were used to calculate SV and CO and to relate them to fat-free body mass (FFM), adipose mass, and demographic variables. Both SV and CO were higher in men than women and in overweight than normal-weight individuals, but these differences were diminished or even reversed by normalization for FFM or body surface area. In both sexes, SV and CO were more strongly related to FFM than adipose mass, other body habitus measures, arterial pressure, diabetes, or age. In multivariate analyses using the average of Doppler and left ventricular SV to minimize measurement variability, FFM was the strongest correlate of SV and CO; other independent correlates were adipose mass, systolic pressure, diabetes, age, and use of digoxin and calcium channel and -blockers.

Conclusions—In a population-based sample, SV and CO are more strongly related to FFM than other variables; increased FFM may be the primary determinant of increased SV and CO in obesity.

Key Words: American Indians • diabetes mellitus • echocardiography • ventricles

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