Associations between waist circumference, central obesity, and the presence of non-valvular atrial fibrillation patients with heart failure

Bing Wang; Xinglin Yang; Bo Wei; Tingting Ren; Niwen Huang; Carlos Escobar; Philip Y K Pang; Xingde Liu; Haiyan Zhou

doi:10.21037/jtd-24-170

Associations between waist circumference, central obesity, and the presence of non-valvular atrial fibrillation patients with heart failure

J Thorac Dis. 2024 Mar 29;16(3):2049-2059. doi: 10.21037/jtd-24-170. Epub 2024 Mar 27.

Authors

Bing Wang^#^{1

2}, Xinglin Yang^#³, Bo Wei^#¹, Tingting Ren³, Niwen Huang¹, Carlos Escobar⁴, Philip Y K Pang⁵, Xingde Liu², Haiyan Zhou^{1

6}

Affiliations

¹ Department of Cardiology, The Affiliated Hospital of Guizhou Medical University, Guiyang, China.
² Department of Internal Medicine, School of Clinical Medicine, Guizhou Medical University, Guiyang, China.
³ Department of Laboratory, Guiyang Public Health Clinical Center, Guiyang, China.
⁴ Cardiology Department, Hospital Universitario La Paz, Madrid, Spain.
⁵ Department of Cardiothoracic Surgery, National Heart Centre Singapore, Singapore, Singapore.
⁶ Department of Physiology and Biophysics, University of Washington, Seattle, WA, USA.

^# Contributed equally.

Abstract

Background: Reportedly, there is a clear correlation between waist circumference (WC) and atrial fibrillation (AF). However, there is no specific discussion about the relationship between WC and non-valvular AF (NVAF) patients with heart failure. Our main purpose was to study the relationship between WC, central obesity (CO), and NVAF patients with heart failure.

Methods: This is a retrospective cohort study. A total of 3,435 patients with NVAF in the First Affiliated Hospital of Xinjiang Medical University from January 2015 to December 2017 were enrolled. The targeted independent variable and the dependent variable were WC and CO and the presence of NVAF with heart failure, respectively. Univariate, multiple regression, and subgroup analyses were used to analyze their relationship. We used the receiver operating characteristic (ROC) curve to choose the better predictor of NVAF with heart failure between WC and CO and calculated the proposed cut-off value of WC in males and female separately.

Results: The identified risk factors of NVAF with heart failure were sex, height, WC, CO, body mass index (BMI), fasting blood glucose (FBG), homocysteine (HCY), triglyceride (TG), low-density lipoprotein cholesterol (LDLC), hypertension, diabetes mellitus (DM), stroke, vascular disease, and plaque. Then, a binary logistic regression model indicated that the occurrence of NVAF patients with heart failure increased 10% with WC increasing 1 cm and had a 2.8-fold increased risk with CO compared to those without. The predictive value [area under the ROC curve (AUC)], specificity, sensitivity, and accuracy of WC for the disease risk of NVAF with heart failure were higher than those of CO. The proposed cut-off value of WC was 91.85 cm for males and 93.15 cm for females. The diagnostic value of WC for NVAF with heart failure was higher for females than it was for males.

Conclusions: Our research found that WC is related to the presence of heart failure in the patients with NYAF and can predict the presence of NVAF with heart failure. Our findings may help to improve the treatment and care strategies of NVAF individuals with abdominal obesity.

Keywords: Waist circumference (WC); central obesity (CO); heart failure; non-valvular atrial fibrillation (NVAF).