Document Detail


Influence of etiology of heart failure on the obesity paradox.
MedLine Citation:
PMID:  19801034     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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:
Type:  Comparative Study; Journal Article; Multicenter Study; Research Support, N.I.H., Extramural     Date:  2009-08-28
Journal Detail:
Title:  The American journal of cardiology     Volume:  104     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-10-05     Completed Date:  2009-10-20     Revised Date:  2013-05-31    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1116-21     Citation Subset:  AIM; IM    
Affiliation:
Department of Physical Therapy, Virginia Commonwealth University, Richmond, Virginia, USA. Raarena@vcu.edu
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MeSH Terms
Descriptor/Qualifier:
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:
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
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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