Obesity increases cardiovascular mortality in patients with HFmrEF

Zhican Liu; Yiqun Peng; Wenjiao Zhao; Yunlong Zhu; Mingxin Wu; Haobo Huang; Ke Peng; Lingling Zhang; Sihao Chen; Xin Peng; Na Li; Hui Zhang; Yuying Zhou; Yongliang Chen; Sha Xiao; Jie Fan; Jianping Zeng

doi:10.3389/fcvm.2022.967780

Obesity increases cardiovascular mortality in patients with HFmrEF

Front Cardiovasc Med. 2022 Sep 8:9:967780. doi: 10.3389/fcvm.2022.967780. eCollection 2022.

Authors

Zhican Liu^{1

2}, Yiqun Peng¹, Wenjiao Zhao¹, Yunlong Zhu¹, Mingxin Wu¹, Haobo Huang¹, Ke Peng³, Lingling Zhang¹, Sihao Chen^{1

2}, Xin Peng^{1

2}, Na Li^{1

2}, Hui Zhang^{1

2}, Yuying Zhou^{1

2}, Yongliang Chen^{1

2}, Sha Xiao^{1

2}, Jie Fan¹, Jianping Zeng^{1

2}

Affiliations

¹ Department of Cardiology, Xiangtan Central Hospital, Xiangtan, China.
² Graduate Collaborative Training Base of Xiangtan Central Hospital, Hengyang Medical School, University of South China, Hengyang, China.
³ Department of Scientific Research, Xiangtan Central Hospital, Xiangtan, China.

Abstract

Background: High body mass index increases the risk of heart failure morbidity and mortality. It is unclear whether a high body mass index is associated with prognosis in patients with heart failure with mildly reduced left ventricular ejection fraction (HFmrEF). We retrospectively analyzed the effect of a high body mass index on the prognosis of patients with HFmrEF.

Methods: We investigated the association between body mass index and cardiovascular death (death from any cardiovascular mechanism) in 1,691 HFmrEF patients (mean age, 68 years; 35% female) in Xiangtan Central Hospital. Using Cox proportional hazards models, body mass index was assessed as a continuous and a categorical variable.

Results: Cardiovascular death occurred in 133 patients (82 males and 51 females) after 1 year of follow-up. After adjustment for established risk factors, there was a 7.5% increase in the risk of cardiovascular death for females for each increment of 1 in BMI. In contrast, changes in male body mass index were not significantly associated with cardiovascular death (P = 0.097). Obese subjects had a 1.8-fold increased risk of cardiovascular death compared with subjects with a normal body mass index. The hazard ratio for females was 2.163 (95% confidence interval: 1.150-4.066). Obesity was not significantly associated with cardiovascular death in males (P = 0.085).

Conclusion: An increased body mass index is associated with an increased risk of cardiovascular death in patients with HFmrEF; however, this risk was mainly associated with female patients with HFmrEF and less with male patients with HFmrEF.

Keywords: HFmrEF; body mass index; cardiovascular; heart failure; mortality; obese.