{
  "abstract": "Introduction In addition to hypertension, the constellation of metabolic abnormalities (diabetes mellitus, dyslipidaemia and/or obesity) independently increases the incidence and severity of cardiovascular diseases, and this is compounded by the modern lifestyle and ageing society. The prevalence of metabolic syndrome is high and non-hypertensive heart failure is common in Asians. Adverse cardiac remodelling is an important substrate for cardiac dysfunction in the onset and progression of heart failure and its amelioration improves outcomes and prognosis. A better understanding of metabolic-driven cardiac remodelling is warranted due to the rising prevalence and complexity of metabolic syndrome and strong interests in targeted therapy.Methods and analysis Response of the myocardium to hypertrophic conditions in the adult population is a prospective observational cohort study with an aim to establish the significance of cardiac remodelling by cardiovascular magnetic resonance (CMR). The current recruitment target is 2000 participants. Expanding from the initial population with hypertension, the study examines adults with cardiometabolic conditions, including diabetes, dyslipidaemia, obesity and fatty liver disease. Eligible patients are identified at National Heart Centre Singapore, primary care clinics and through public outreach. Physical, clinical, imaging and biochemical data are collected. Cardiac remodelling features pertaining to hypertrophy, fibrosis and functional changes are assessed on CMR. Body adiposity is mapped by MRI across the heart, liver and abdomen. Outcome data are adjudicated and follow-up assessment will be available in a subset of participants. Blood biomarkers will be investigated in relation to imaging findings. Cross-sectional analysis will establish the implication of cardiometabolic disease towards cardiac remodelling, while follow-up and outcome analysis will infer on disease progression and prognosis.Ethics and dissemination The study was approved by the SingHealth Centralised Institutional Review Board (2015/2603). Written informed consent is obtained from all participants. Study findings will be reported in peer-reviewed journals and at scientific conferences.Trial registration number ClinicalTrials.gov, NCT02670031.",
  "authors": [
    {
      "affiliations": [
        "National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore"
      ],
      "name": "Vivian Lee"
    },
    {
      "affiliations": [
        "Department of Endocrinology, Changi General Hospital, Singapore"
      ],
      "name": "Troy Puar"
    },
    {
      "affiliations": [
        "Department of Cardiology, National Heart Centre Singapore, Singapore"
      ],
      "name": "Michelle SL Kui"
    },
    {
      "affiliations": [
        "Department of Cardiology, National Heart Centre Singapore, Singapore"
      ],
      "name": "Jennifer A Bryant"
    },
    {
      "affiliations": [
        "Department of Cardiology, National Heart Centre Singapore, Singapore"
      ],
      "name": "Yiying Han"
    },
    {
      "affiliations": [
        "Clinical and Translational Research Office, National Heart Centre Singapore, Singapore"
      ],
      "name": "Aisyah Binte Latib"
    },
    {
      "affiliations": [
        "Clinical and Translational Research Office, National Heart Centre Singapore, Singapore"
      ],
      "name": "Warren Tay"
    },
    {
      "affiliations": [
        "Clinical and Translational Research Office, National Heart Centre Singapore, Singapore"
      ],
      "name": "Siew Ching Kong"
    },
    {
      "affiliations": [
        "National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore"
      ],
      "name": "Desiree-Faye Toh"
    },
    {
      "affiliations": [
        "National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore",
        "Cardiovascular Academic Clinical Program, Duke-NUS Medical School, Singapore"
      ],
      "name": "Redha Boubertakh"
    },
    {
      "affiliations": [
        "Department of Medicine, National University of Singapore Yong Loo Lin School of Medicine, Singapore"
      ],
      "name": "Chi-Hang Lee"
    },
    {
      "affiliations": [
        "National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore",
        "Cardiovascular Academic Clinical Program, Duke-NUS Medical School, Singapore"
      ],
      "name": "Thu-Thao Le"
    },
    {
      "affiliations": [
        "National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore",
        "Department of Cardiology, National Heart Centre Singapore, Singapore",
        "Cardiovascular Academic Clinical Program, Duke-NUS Medical School, Singapore"
      ],
      "name": "Calvin W L Chin"
    }
  ],
  "title": "Response of the myocardium to hypertrophic conditions in the adult population (REMODEL): protocol for a prospective observational cohort study",
  "uid": "41154192-e1ba-5540-a421-afbf64d71d07"
}