| Influence of etiology of heart failure on the obesity paradox. | |
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MedLine Citation:
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PMID: 19801034 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Several investigations have demonstrated that higher body weight, as assessed by the body mass index, is associated with improved prognosis in patients with heart failure (HF). The purpose of the present investigation was to assess the influence of HF etiology on the prognostic ability of the body mass index in a cohort undergoing cardiopulmonary exercise testing. A total of 1,160 subjects were included in the analysis. All subjects underwent cardiopulmonary exercise testing, at which the minute ventilation/carbon dioxide production slope and peak oxygen consumption were determined. In the overall group, 193 cardiac deaths occurred during a mean follow-up of 30.7 +/- 25.6 months (annual event rate 6.0%). The subjects classified as obese consistently had improved survival compared to those classified as normal weight (overall survival rate 88.0% vs <or=81.1%, p <0.001). Differences in survival according to HF etiology were observed for those classified as overweight. In the ischemic subgroup, the survival characteristics for the overweight subjects (75.5%) were similar those for subjects classified as normal weight (81.1%). The converse was true for the nonischemic subgroup, for whom the survival trends for the obese (86.4%) and overweight subjects (88.4%) were similar. The minute ventilation/carbon dioxide production slope was the strongest prognostic marker (chi-square >or=43.4, p <0.001) for both etiologies, and the body mass index added prognostic value (residual chi-square >or=4.7, p <0.05). In conclusion, these results further support the notion that obesity confers improved prognosis in patients with HF, irrespective of the HF etiology. Moreover, the body mass index appears to add predictive value during the cardiopulmonary exercise testing assessment. However, survival appears to differ according to HF etiology in subjects classified as overweight. |
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Authors:
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Ross Arena; Jonathan Myers; Joshua Abella; Sherry Pinkstaff; Peter Brubaker; Brian Moore; Dalane Kitzman; Mary Ann Peberdy; Daniel Bensimhon; Paul Chase; Daniel Forman; Erin West; Marco Guazzi |
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Publication Detail:
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Type: Comparative Study; Journal Article; Multicenter Study; Research Support, N.I.H., Extramural Date: 2009-08-28 |
Journal Detail:
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Title: The American journal of cardiology Volume: 104 ISSN: 1879-1913 ISO Abbreviation: Am. J. Cardiol. Publication Date: 2009 Oct |
Date Detail:
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Created Date: 2009-10-05 Completed Date: 2009-10-20 Revised Date: 2013-05-31 |
Medline Journal Info:
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Nlm Unique ID: 0207277 Medline TA: Am J Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 1116-21 Citation Subset: AIM; IM |
Affiliation:
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Department of Physical Therapy, Virginia Commonwealth University, Richmond, Virginia, USA. Raarena@vcu.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Body Mass Index Cause of Death / trends Exercise Test Female Follow-Up Studies Heart Failure / diagnosis, etiology*, mortality Humans Incidence Italy / epidemiology Male Middle Aged Obesity / complications*, epidemiology, metabolism Oxygen Consumption Prognosis Risk Factors Survival Rate / trends United States / epidemiology |
| Grant Support | |
ID/Acronym/Agency:
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M01 RR007122-178332/RR/NCRR NIH HHS; P60 AG010484-10/AG/NIA NIH HHS; P60AG10484/AG/NIA NIH HHS; R01 AG012257-07/AG/NIA NIH HHS; R01 AG018915-04/AG/NIA NIH HHS; R37 AG018915/AG/NIA NIH HHS; R37 AG018915-05/AG/NIA NIH HHS; R37AG18915/AG/NIA NIH HHS |
| Comments/Corrections | |
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