Is the obesity paradox in outpatients with heart failure reduced ejection fraction real?
The obesity occurrence has achieved epidemic levels worldwide and several studies indicate a paradoxical similarity among obesity and the prognosis in heart failure (HF). The primary objective was to understand the association between body mass index (BMI) and heart failure with reduced ejection fra...
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Published in | Frontiers in cardiovascular medicine Vol. 10; p. 1239722 |
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Main Authors | , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
Switzerland
Frontiers Media S.A
11.12.2023
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Subjects | |
Online Access | Get full text |
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Summary: | The obesity occurrence has achieved epidemic levels worldwide and several studies indicate a paradoxical similarity among obesity and the prognosis in heart failure (HF). The primary objective was to understand the association between body mass index (BMI) and heart failure with reduced ejection fraction (HFREF) of ischemic etiology in outpatients, using mortality as a parameter. The secondary objectives were to determine the differences in HF functional class, pharmacological therapy and evaluate the prognostic value of MAGGIC Score in this population.
We analyzed 1,556 medical records from the HF outpatient clinic of a quaternary hospital and 242 were selected according to the criteria. Most were male, average age 62.6 (56-70), BMI 18.5-24.9 = 35.1%, 25-29.9 = 37.2%, 30-34.9 = 17.8%, 35-39.9 = 7%; BMI <18.5 and >40 groups were eliminated from the central analyzes because of scarce testing.
BMI 30-34.9 and BMI 18.5-24.9 had the best prognosis, BMI 25-29.9 had an average performance, and BMI -39.9 group provided the worst outcome (
= 0.123). In the subcategory analysis, BMI 30-34.9 group had a better prognosis compared to the BMI 35-39.9 group (
= 0.033). In the multivariate analysis The MAGGIC score was not able to foretell mortality in this population according to BMI.
In not hospitalized patients with HFREF of ischemic etiology, obesity was not a protective factor. |
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Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Sonia Eiras, Health Research Institute of Santiago de Compostela (IDIS), Spain Abbreviations HF, heart failure; BMI, body mass index; HFREF, heart failure reduced ejection fraction; HFPEF, heart failure preserved ejection fraction; CKD, chronic kidney disease; COPD, chronic obstructive pulmonary disease; ARB, angiotensin receptor blockers; ACE-I, angiotensin-converting enzyme inhibitors; ARNI, angiotensin receptor-neprilysin inhibitor; MRA, mineralocorticoid receptor antagonist; NYHA, New York Heart Association; DM, diabetes mellitus. Reviewed by: Claudia Penna, University of Turin, Italy Edited by: Tarek Bekfani, University Hospital Magdeburg, Germany |
ISSN: | 2297-055X 2297-055X |
DOI: | 10.3389/fcvm.2023.1239722 |