Document Detail


Disparate effects of left ventricular geometry and obesity on mortality in patients with preserved left ventricular ejection fraction.
MedLine Citation:
PMID:  17950808     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Left ventricular (LV) geometry predicts cardiovascular events. Although obesity is a risk factor for cardiovascular diseases, studies have noted a paradox regarding obesity and prognosis. To our knowledge no studies have determined the impact of obesity on LV geometry as well as mortality in patients with preserved ejection fraction. We evaluated 30,920 patients with preserved ejection fraction, including 11,792 obese patients as well as 19,128 nonobese patients to determine the impact of 4 LV geometric patterns, including normal structure, concentric remodeling (CR), as well as eccentric or concentric hypertrophy and obesity on mortality during an average follow-up of 3.2 +/- 1.4 years. Abnormal LV geometry occurred more commonly in obese than nonobese patients (49% vs 44%, p <0.0001 for the difference in the 4 patterns). In obese patients, CR was the most prevalent abnormal pattern (34%), with eccentric and concentric LV hypertrophy occurring in 7% and 8%, respectively, compared with nonobese patients (32%, 6%, and 6%, respectively). Overall mortality was considerably lower in obese than nonobese (3.9% vs 6.5%, p <0.0001). In both groups, progressive increases in mortality compared with normal structure occurred with CR, eccentric and concentric LV hypertrophy (obese patients 2.8%, 4.8%, 5.3%, and 6.9%, respectively; and nonobese patients 4.3%, 8.4%, 9.6%, and 11.8%, respectively). In conclusion, although an obesity paradox exists, in that obesity is associated with higher prevalence of structural abnormalities but lower mortality than in nonobese patients, our data demonstrate that LV geometric abnormalities are prevalent in both obese and nonobese patients with normal ejection fraction and are associated with progressive increases in mortality.
Authors:
Carl J Lavie; Richard V Milani; Hector O Ventura; Gustavo A Cardenas; Mandeep R Mehra; Franz H Messerli
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Publication Detail:
Type:  Journal Article     Date:  2007-08-27
Journal Detail:
Title:  The American journal of cardiology     Volume:  100     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2007 Nov 
Date Detail:
Created Date:  2007-10-22     Completed Date:  2007-12-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1460-4     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiology, Ochsner Medical Center, New Orleans, LA, USA. clavie@ochsner.org
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Female
Humans
Hypertrophy, Left Ventricular / epidemiology*,  mortality,  pathology*,  ultrasonography
Male
Middle Aged
Obesity / epidemiology*,  pathology*
Prevalence
Prognosis
Retrospective Studies
Risk Factors
Stroke Volume*
Ventricular Remodeling*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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