scholarly journals Correlation Between Body Mass Index and Echocardiographic Findings in Overweight Patients Compared to Normal-Weight Patients

2017 ◽  
Vol 2 (3) ◽  
pp. 102
Author(s):  
Mohammad Salehi ◽  
Mehdi Latif ◽  
Fatemeh Peighambari ◽  
Mohammad Dehestani ◽  
Seyed Vahid Ahmadi-Hanzaei
Keyword(s):  
Heart Failure ◽  
Body Mass Index ◽  
Body Mass ◽  
Diastolic Heart Failure ◽  
Left Ventricular ◽  
Normal Weight ◽  
Historical Cohort ◽  
Overweight Group ◽  
Group 2 ◽  
Echocardiographic Findings

Background: Overweight is currently considered as the main risk factor for various chronic disorders, especially cardiovascular diseases. Unexpected hypertension is the first reaction of heart to overburden imposed by obesity or overweight. The purpose of the present study was to evaluate the correlation between body mass index (BMI) and echocardiographic findings in overweight patients compared with normal-weight population.methods: This historical cohort study was conducted on 60 patients divided into two group of 30 based on their measured weights, group 1 with BMI of 20-25 kg/m2 as control and group 2 with 25<BMI≤30 kg/m2. All demographic and clinical data along with the echocardiographic findings were recorded for all samples.Results: The mean age of control (41.06 ± 12.82 years) and oversights (46.84 ± 12.61 years) was not significantly different (P = 0.067). Systolic blood pressure (P = 0.003) and pulse rate (P = 0.028) were significantly higher in overweight group; ejection fraction (P = 0.036), end-systolic (P < 0.001) and end-diastolic (P < 0.001) left ventricular dimensions, and left ventricular mass index (P = 0.005) were significantly higher in control group.Conclusion: Overweighting due to anatomical remodeling can cause diastolic heart failure in left ventricle. According to the relatively poor prognosis of treatment features in patients with probable risk factors of heart failure such as diabetes, hypertension and ischemic heart disease (IHD), it is recommended to consider overweight as an effective prognostic factor. 

Association of Body Mass Index With Clinical Outcomes in Patients With Heart Failure With Reduced Ejection Fraction Treated With Sacubitril/Valsartan

2021 ◽  
pp. 107424842110244
Author(s):  
Kazuhiko Kido ◽  
Christopher Bianco ◽  
Marco Caccamo ◽  
Wei Fang ◽  
George Sokos
Keyword(s):  
Heart Failure ◽  
Body Mass Index ◽  
Propensity Score ◽  
Ejection Fraction ◽  
Clinical Outcomes ◽  
Body Mass ◽  
Normal Weight ◽  
Reduced Ejection Fraction ◽  
Propensity Score Weighting ◽  
Patients With Heart Failure

Background: Only limited data are available that address the association between body mass index (BMI) and clinical outcomes in patients with heart failure with reduced ejection fraction who are receiving sacubitril/valsartan. Methods: We performed a retrospective multi-center cohort study in which we compared 3 body mass index groups (normal, overweight and obese groups) in patients with heart failure with reduced ejection fraction receiving sacubitril/valsartan. The follow-up period was at least 1 year. Propensity score weighting was performed. The primary outcomes were hospitalization for heart failure and all-cause mortality. Results: Of the 721 patients in the original cohort, propensity score weighting generated a cohort of 540 patients in 3 groups: normal weight (n = 78), overweight (n = 181), and obese (n = 281). All baseline characteristics were well-balanced between 3 groups after propensity score weighting. Among our results, we found no significant differences in hospitalization for heart failure (normal weight versus overweight: average hazard ratio [AHR] 1.29, 95% confidence interval [CI] = 0.76-2.20, P = 0.35; normal weight versus obese: AHR 1.04, 95% CI = 0.63-1.70, P = 0.88; overweight versus obese groups: AHR 0.81, 95% CI = 0.54-1.20, P = 0.29) or all-cause mortality (normal weight versus overweight: AHR 0.99, 95% CI = 0.59-1.67, P = 0.97; normal weight versus obese: AHR 0.87, 95% CI = 0.53-1.42, P = 0.57; overweight versus obese: AHR 0.87, 95% CI = 0.58-1.32, P = 0.52). Conclusion: We identified no significant associations between BMI and clinical outcomes in patients diagnosed with heart failure with a reduced ejection fraction who were treated with sacubitril/valsartan. A large-scale study should be performed to verify these results.

scholarly journals Weight evolution after implantation of left ventricular assist device: Do we need to interfere?

2020 ◽  
Vol 43 (10) ◽  
pp. 671-676
Author(s):  
Katrien Vandersmissen ◽  
Steven Jacobs ◽  
Libera Fresiello ◽  
Kathleen Gerits ◽  
Marieke Roppe ◽  
...  
Keyword(s):  
Heart Failure ◽  
Body Mass Index ◽  
Body Mass ◽  
Functional Capacity ◽  
Left Ventricular Assist Device ◽  
Ventricular Assist Device ◽  
Left Ventricular ◽  
Assist Device ◽  
Ventricular Assist ◽  
Left Ventricular Assist

Objectives: Weight change after left ventricular assist device implantation may influence outcomes and can affect transplant candidacy. We questioned if there is a systematic weight change after left ventricular assist device implantation and examined the evolution in functional capacity. Methods: A retrospective analysis of 84 patients who received a left ventricular assist device in Universitaire Ziekenhuizen Leuven between 2008 and 2016 was performed. Patients were divided into four groups based on their baseline body mass index, and we also examined weight evolution for patients presenting with new-onset heart failure versus those suffering from chronic heart failure. Body mass index was assessed at baseline, 6, 12, 18, and 24 months. To indicate the functional capacity, we analyzed the results of routine 6-Minute Walk Test performed at 6, 12, and 18 months. Results: During the first 6 months after surgery, the underweight patients evolved to normal weight and the body mass index of the obese patients reduced significantly. Afterward, all patients gained weight. The weight loss of the obese was not maintained over time. The weight of patients with normal weight and overweight evolved to overweight and obesity, respectively. No body mass index changes were demonstrated for patients presenting with new-onset heart failure, and the body mass index of patients suffering from chronic HF significantly increased. There was a significant improvement in functional capacity at 6 months, but this level remained unchanged at 12 and 18 months after surgery. Conclusion: Although the initial 6 months evolve beneficial, all patients gain weight in the second year and do not further improve their exercise capacity.

Body mass index and outcomes in ischaemic versus non-ischaemic heart failure across the spectrum of ejection fraction

2020 ◽  
pp. 204748732092761
Author(s):  
Francesco Gentile ◽  
Paolo Sciarrone ◽  
Elisabet Zamora ◽  
Marta De Antonio ◽  
Evelyn Santiago ◽  
...  
Keyword(s):  
Heart Failure ◽  
Body Mass Index ◽  
Ejection Fraction ◽  
Body Mass ◽  
Left Ventricular ◽  
Hazard Ratio ◽  
Left Ventricular Ejection ◽  
Heart Failure Patients ◽  
All Cause Mortality ◽  
Mild Obesity

Aims Obesity is related to better prognosis in heart failure with either reduced (HFrEF; left ventricular ejection fraction (LVEF) <40%) or preserved LVEF (HFpEF; LVEF ≥50%). Whether the obesity paradox exists in patients with heart failure and mid-range LVEF (HFmrEF; LVEF 40–49%) and whether it is independent of heart failure aetiology is unknown. Therefore, we aimed to test the prognostic value of body mass index (BMI) in ischaemic and non-ischaemic heart failure patients across the whole spectrum of LVEF. Methods Consecutive ambulatory heart failure patients were enrolled in two tertiary centres in Italy and Spain and classified as HFrEF, HFmrEF or HFpEF, of either ischaemic or non-ischaemic aetiology. Patients were stratified into underweight (BMI <18.5 kg/m2), normal-weight (BMI 18.5–24.9 kg/m2), overweight (BMI 25–29.9 kg/m2), mild-obese (BMI 30–34.9 kg/m2), moderate-obese (BMI 35–39.9 kg/m2) and severe-obese (BMI ≥40 kg/m2) and followed up for the end-point of five-year all-cause mortality. Results We enrolled 5155 patients (age 70 years (60–77); 71% males; LVEF 35% (27–45); 63% HFrEF, 18% HFmrEF, 19% HFpEF). At multivariable analysis, mild obesity was independently associated with a lower risk of all-cause mortality in HFrEF (hazard ratio, 0.78 (95% confidence interval (CI) 0.64–0.95), p = 0.020), HFmrEF (hazard ratio 0.63 (95% CI 0.41–0.96), p = 0.029), and HFpEF (hazard ratio 0.60 (95% CI 0.42–0.88), p = 0.008). Both overweight and mild-to-moderate obesity were associated with better outcome in non-ischaemic heart failure, but not in ischaemic heart failure. Conclusions Mild obesity is independently associated with better survival in heart failure across the whole spectrum of LVEF. Prognostic benefit of obesity is maintained only in non-ischaemic heart failure.

Abstract 16775: Body Mass Index Predicts Exercise Capacity in Patients With Hypertrophic Cardiomyopathy

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Caroline A Ball ◽  
Carolyn M Larsen ◽  
Virginia Hebl ◽  
Jeffrey B Geske ◽  
Kevin C Ong ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Hypertrophic Cardiomyopathy ◽  
Body Mass ◽  
Exercise Testing ◽  
Cardiopulmonary Exercise Testing ◽  
Systolic Pressure ◽  
Left Ventricular ◽  
Normal Weight ◽  
Peak Vo2 ◽  
Significant Difference

Introduction: Impaired peak VO2 and obesity are known predictors of morbidity and mortality in Hypertrophic Cardiomyopathy (HCM). The purpose of this study is to determine the degree of exercise impairment due to excess weight in patients with HCM. Methods: Adult HCM patients who underwent cardiopulmonary treadmill testing at our tertiary referral center from 2006 - 2012 and had consented to research participation were identified retrospectively. Percent predicted peak VO2 was calculated by the Astrand formula for men and the Jones formula for women which adjust for age and gender. Baseline echocardiographic features obtained within 1 week of exercise testing and % predicted peak VO2 were compared among four groups of patients stratified by body mass index (BMI). Results: 510 patients were identified, with a mean age at diagnosis of 44.3 ± 16.1 years, 186 (36.5%) female. Mean BMI at the time of cardiopulmonary exercise testing was 29.7 ± 5.3 and 227 (44.6%) patients had a BMI ≥ 30. Overweight and obese patients were older and were more likely to be male than their normal weight peers. However, there was no significant difference in ejection fraction (EF), resting left ventricular outflow tract gradient, right ventricular systolic pressure (RVSP), or septal thickness among the groups. HCM patients show impaired peak VO2 across all BMI groups. While peak VO2 increased progressively across BMI groups consistent with greater O2 demand generated by higher body weight, the adjusted peak VO2 in mL/kg/min fell progressively, indicating progressively greater performance impairment with increasing BMI despite similar degrees of cardiac impairment (p <0.0001) (Table 1). Conclusion: Increased BMI is associated with reduced exercise performance in a graded manner in HCM patients independent of cardiac impairment identified on echocardiography.

Balance Assessment Using Multi-Directional Reach Test in Community-Dwelling Elderly People with Different Body Mass Index

2021 ◽  
Vol 104 (12) ◽  
pp. 1908-1912
Keyword(s):  
Body Mass Index ◽  
Elderly People ◽  
Body Mass ◽  
Cross Sectional Study ◽  
Normal Weight ◽  
Community Dwelling ◽  
Balance Assessment ◽  
Weight Group ◽  
Cross Sectional ◽  
Overweight Group

Objective: To assess ability of balance in community-dwelling elderly people with different body mass index (BMI) using multi-directional reach test (MDRT) test. Materials and Methods: The cross-sectional study design was used to evaluate the effects of body mass index (BMI) on ability of balance using MDRT in community-dwelling elderly people. Results: Obese community-dwelling elderly people had the lowest scores in all directions of MDRT when compared with those of normal weight and overweight groups. Furthermore, in overweight group, the scores in all directions of MDRT were significantly reduced compared to those of normal weight group (p<0.05). Moreover, the scores of MDRT were negatively correlated with BMI (p<0.05). Conclusion: Obese and overweight community-dwelling elderly people had decreased ability of balance. Additionally, BMI was negatively correlated with the scores of MDRT in community-dwelling elderly people. Keywords: Body mass index; Multi-directional reach test; Falls; Elderly; Balance

Does obesity influence ventricular repolarisation in children?

2020 ◽  
pp. 1-9
Author(s):  
Nihan Yıldırım Yıldız ◽  
Tayfun Uçar ◽  
Mehmet G. Ramoğlu ◽  
Merih Berberoğlu ◽  
Zeynep Şıklar ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Body Mass Index ◽  
Body Mass ◽  
Wall Thickness ◽  
Left Ventricular ◽  
Normal Weight ◽  
Qtc Interval ◽  
Healthy Children ◽  
Obese Children ◽  
Ventricular Repolarisation

Abstract Objective: Ventricular repolarisation changes may lead to sudden cardiac death in obese individuals. We aimed to investigate the relationship between ventricular repolarisation changes, echocardiographic parameters, anthropometric measures, and metabolic syndrome laboratory parameters in obese children. Methods: The study involved 81 obese and 82 normal-weight healthy children with a mean age of 12.3 ± 2.7 years. Anthropometric measurements of participants were evaluated according to nomograms. Obese patients were subdivided into two groups; metabolic syndrome and non-metabolic syndrome obese. Fasting plasma glucose, fasting insulin, and lipid profile were measured. QT/QTc interval, QT/QTc dispersions were measured, and left ventricular systolic and diastolic measurements were performed. Results: Body weight, body mass index, relative body mass index, waist/hip circumference ratio, and systolic and diastolic blood pressures were significantly higher in obese children. QT and QTc dispersions were significantly higher in obese children and also obese children with metabolic syndrome had significantly higher QT and QTc dispersions compared to non-metabolic syndrome obese children (p < 0.001) and normal-weight healthy children (p < 0.001). Waist/hip circumference ratio, body mass index, and relative body mass index were the most important determinant of QT and QTc dispersions. Left ventricular wall thickness (left ventricular posterior wall thickness at end-diastole, left ventricular posterior wall thickness at end-systole, interventricular septal thickness at end-diastole) and left ventricular mass index were significantly higher and ejection fraction was lower in obese children. Left ventricular mass index and interventricular septal thickness at end-diastole were positively correlated with QT and QTc dispersions. Conclusions: Our study demonstrated that QT/ QTc interval prolongation and increase in QT and QTc dispersion on electrocardiogram may be found at an early age in obese children.

scholarly journals Influence of preoperative weight on the early and middle outcome of fixed platform medial unicompartmental knee arthroplasty

2020 ◽  
Vol 8 (9_suppl7) ◽  
pp. 2325967120S0054
Author(s):  
Chen Wenzhong ◽  
Zou Shiping ◽  
Siwen Teng
Keyword(s):  
Body Mass Index ◽  
Knee Osteoarthritis ◽  
Body Mass ◽  
Normal Weight ◽  
Obese Group ◽  
Weight Group ◽  
P Values ◽  
Overweight Group ◽  
Hss Score ◽  
Incision Healing

Introduction: Obesity is an important independent risk factor for the development of knee osteoarthritis .According to the data of the world Health Organization, there were more than 1.9 billion overweight adults in the world in 2014, among which at least 600 million were clinically obese .Therefore, among the patients undergoing knee replacement, the number of obese patients is increasing .The use of single condyle replacement for medial compartment arthritis of the knee began in the 1970s.With the continuous development of new implants, the continuous improvement of surgical techniques and the strict control of indications by surgeons, the 15-year survival rate of single condyle replacement is over 90%, and the 20-year survival rate is 84%, achieving good results.In the indications of knee monocepicondylar replacement, the maximum weight standard has been increased from 82kg in 1989 [8] to 90kg in 2002 [9].However, there is still controversy over the body weight cut-off point in the indications, especially the observation on the postoperative effect of single condyle replacement in obese patients, which has been rarely reported in China. Hypotheses: To evaluate the near and middle term efficacy of unicompartmental knee arthroplasty(UKA) in patients with medial knee osteoarthritis with different body mass index, and to determine the effect of body weight on the efficacy and complications of UKA. Methods: A total of 128 patients who underwent UKA in department I of arthropathy, zhengzhou orthopaedic hospital from December 2016 to December 2018 due to medial knee osteoarthritis were included as study subjects, and the clinical data of the study subjects were retrospectively analyzed. There were 29 males and 99 females, with an average age of 65.13± 7.37 years (range: 51˜87 years).According to the preoperative body mass index (BMI), the subjects were divided into three groups, namely the underweight or normal weight group (BMI < 24kg /㎡), the overweight group (24kg /㎡≤BMI < 28kg /㎡) and the obese group (BMI≥ 28kg /㎡).Visual analogue scale (VAS), knee range of motion(ROM), American hospital for special surgery (HSS) score of knee joint, complications and other relevant indicators were recorded before and at the last follow-up for each group. According to the data types of preoperative and postoperative efficacy evaluation indexes of the same group, paired sample T test, c² test or Wilcoxon sign rank sum test were used for difference analysis. One-way anova, c² test or K-W rank sum test were used to evaluate the difference between groups. Results: All subjects were followed up for 13-37 months (22.34± 7.22).Compared with before surgery, VAS scores of patients in the last follow-up were significantly lower in the underweight or normal weight group, the overweight group and the obese group (6.91±6.34 vs. 0.44±0.67, 6.90 ±0.77 vs. 0.63±0.68, 6.78±0.71 vs. 0.59±0.61) (t= 46.488-42.654,P values <0.01), knee ROM significantly increased (97.67±10.87 vs. 114.77±8.01, 98.96±10.67 vs. 116.03±6.96, 95.31±11.50 vs. 110.93±11.46) (t= -20.83 - -11.039,All P values were <0.01), and knee HSS score was significantly improved (51.63±0.61 vs 88.00±4.06, 50.68±6.46 vs 87.87±5.73, 48.25±6.70 vs 87.03±5.17) (t= -48.920- -34.010, all P values <0.01).There were no statistically significant differences in VAS score, knee ROM and knee HSS score between the overweight group and the obese group compared with the underweight or normal group. None of the patients had serious complications such as periprosthesis infection, simple prosthesis loosening and periprosthesis fracture. The incidence of venous thrombosis in lower extremities was 14.06% (18/128), with no significant difference between groups. There were 7 cases of poor incision healing (overweight group is 3 and obese group is 4), and the risk of poor incision healing was higher in the obese group than in the underweight or normal weight group, with statistical significance (P=0.03). Conclusion: UKA can achieve satisfactory clinical effect in patients with different body mass index, but patients in obesity group are prone to complications such as poor incision healing.

Abstract 15543: Association Between Body Mass Index and Prognosis of Patients Hospitalized With Heart Failure

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
yuta seko ◽  
Takao Kato ◽  
Takeshi Morimoto ◽  
Hidenori Yaku ◽  
YASUTAKA INUZUKA ◽  
...  
Keyword(s):  
Heart Failure ◽  
Body Mass Index ◽  
Body Mass ◽  
Mortality Risk ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure ◽  
Normal Weight ◽  
World Health ◽  
Prognostic Impact

Background: The prognostic implications of very low body mass index (BMI) values remain unclear in patients with acute decompensated heart failure (ADHF). This study aimed to investigate the prognostic impact of BMI classification based on the World Health Organization criteria in patients with ADHF. Methods and Results: Using data from 4056 consecutive patients with ADHF hospitalized in 19 participating hospitals in Japan between October 2014 and March 2016, we analyzed 3509 patients with available BMI data at discharge. The patients were divided into five groups; (1) Severely underweight: BMI<16 kg/m 2 , (2) Underweight: BMI≥16 kg/m 2 and <18.5 kg/m 2 , (3) Normal weight: BMI≥18.5 kg/m 2 and <25 kg/m 2 , (4) Overweight: BMI≥25 kg/m 2 and <30 kg/m 2 (5) Obese: BMI≥30 kg/m 2 . The primary outcome measure was all-cause death. The median follow-up duration was 471 days, with 96.4% follow up at 1-year. The cumulative 1-year incidence of all-cause death was higher in underweight groups, and lower in overweight groups (Severely underweight: 36.3%, Underweight: 23.9%, Normal weight: 14.4%, Overweight: 7.9%, and Obese: 9.0%, P<0.001). After adjusting confounders, the excess mortality risk remained significant in the severely underweight group (HR, 2.38; 95%CI, 1.88-3.02; P<0.001), and in the underweight group (HR, 1.33; 95%CI, 1.10-1.62; P=0.003) relative to the normal weight group, while the lower mortality risk was no longer significant in the overweight group (HR, 0.76; 95%CI, 0.57-1.01; P=0.06), and in the obese group (HR, 0.89; 95%CI, 0.53-1.50; P=0.66). Conclusions: Lower BMI, not obesity, was associated with a higher risk for all-cause death after discharge in patients with ADHF.

Impact of body mass index on the clinical outcomes in heart failure patients undergoing cardiac rehabilitation

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M Kunimoto ◽  
K Shimada ◽  
M Yokoyama ◽  
K Fujiwara ◽  
A Honzawa ◽  
...  
Keyword(s):  
Heart Failure ◽  
Body Mass Index ◽  
Cardiac Rehabilitation ◽  
Body Mass ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Favorable Effect ◽  
Kaplan Meier ◽  
All Cause Mortality

Abstract Background Increased body mass index (BMI) has recently shown to have a favorable effect on the prognosis in heart failure (HF) patients. However, the impact of BMI on clinical events and mortality in HF patients who underwent cardiac rehabilitation (CR) remains unclear. Purpose This study aimed to investigate whether the obesity paradox is present in HF patients who have undergone CR. Methods This study enrolled 238 consecutive HF patients who had undergone CR at our university hospital between November 2015 and October 2017. The clinical characteristics and anthropometric data of these patients, including BMI, were collected at the beginning of the CR. The major adverse cardiovascular event (MACE) was defined as a composite of all-cause mortality and unplanned hospitalization for HF. Follow-up data regarding the primary endpoints were collected until November 2018. Results Patients (mean age 68.7 years, male 61%) were divided into four groups as per BMI quartiles. More patients in the highest BMI group were women, were significantly younger, and had a higher prevalence of hypertension, dyslipidemia, and diabetes mellitus; however, no significant differences were observed in the prevalence of chronic kidney disease, left ventricular ejection fraction, and brain natriuretic peptide levels of the four groups. During a median follow-up duration of 583 days, 28 patients experienced all-cause mortality, and 42 were hospitalized for HF. Kaplan–Meier analysis showed that patients in the highest BMI quartiles had lower rates of MACE (Log-rank P&lt;0.05) (Figure 1). After adjusting for confounding factors, Cox regression multivariate analysis revealed that BMI was negatively and independently associated with the incidence of MACE (hazard ratio: 0.89, 95% confidence interval: 0.83–0.96, P&lt;0.05). Conclusion Increased BMI was associated with better clinical prognosis even in HF patients who have undergone CR Therefore, BMI assessment may be useful for risk stratification in HF patients who have undergone CR. Figure 1. Kaplan-Meier survival curve Funding Acknowledgement Type of funding source: None

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