medigraphic.com
ISSN 1561-302X (Print)

2022, Number 2

<< Back Next >>

Rev cubana med 2022; 61 (2)

Obesity in the mortality of patients with heart failure and reduced ejection fraction

Chao PC, Hilera AB, Castellanos AD, Gutiérrez RÁR

Language: Spanish
References: 13
Page: 1-11
PDF size: 393.39 Kb.


ABSTRACT

Introduction: The association between obesity and lower mortality in patients with heart failure and left ventricular ejection fraction is controversial.
Objective: To evaluate the association between obesity and mortality in patients with heart failure and reduced ejection fraction.
Methods: An observational prospective cohort study was carried out, from January 2010 to December 2020, in patients with heart failure and reduced ejection fraction. The sample was made up of 173 patients. Survival was evaluated using Kaplan-Meier method to estimate the prognostic effect of the obesity variable on mortality. Cox regression model was used.
Results: It was observed that obese patients at one year of follow-up had better survival than those with normal weight (0.6 versus 0.8). At five years, the three subgroups of body mass index (0.6) showed similar survival and the highest mortality was observed by low weight patients. The curve of the latter differs from the rest of the BMI categories, Log Rank p=0.001. In the Cox regression model, obesity had an odds ratio OR=´1.159 p=0.648 (confidence interval 0.615-2.181).
Conclusions: In patients with heart failure with reduced ejection fraction, the phenomenon of paradoxical obesity was not observed in relation to mortality.


REFERENCES

  1. Chao Pereira C. Obesidad y mortalidad en los pacientes con insuficiencia cardiaca crónica. Rev. Cub. Med. 2018 [acceso: 10/09/2021];57(4):6. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0034-752320180004000041.

  2. Inzunza Cervantes G, Herrera Gavilanes JR, López López RM, Ornelas Aguirre JM, Vidal-Morales R, Peña Valenzuela NA. Insuficiencia cardíaca crónica con fracción de eyección reducida: abordaje teórico, clínico y terapéutico. Rev. Med. UAS. 2021;11(4). http://dx.doi.org/10.28960/revmeduas.2007-8013.v11.n4.0082.

  3. Horwich TB, Fonarow GC, Hamilton MA, et al. The relationship between obesity and mortality in patients with heart failure. J Am Coll Cardiol. 2001;38(3):789-95.

  4. Vest AR, Wu Y, Hachamovitch R, Young JB, Cho L. The Heart Failure Overweight/Obesity Survival Paradox: The Missing Sex Link. JACC Heart Fail. 2015 3(11):917-26. DOI: 10.1016/j.jchf.2015.06.00

  5. Elagizi A, Carbone S, Lavie CJ, Mehra MR, Ventura HO. Implications of obesity across the heart failure continuum. Prog Cardiovasc Dis. 2020;(20)30161-4. DOI: 10.1016/j.pcad.2020.09.005

  6. Chao Pereira C, Ortega Cedeño H, Gutiérrez AR, Casas Morell E. Índice de masa corporal e interleuquina 6 en la mortalidad de pacientes con insuficiencia cardiaca crónica. Rev. Cub. Med. 2018 [acceso: 10/09/2021];57(3)8. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0034-752320180003000046.

  7. Chao Pereira C, Pérez Goelkel SJ, Gutiérrez Rojas AR, Resello Azcanio Y. Índice de masa corporal y mortalidad en pacientes diabéticos tipo 2 con insuficiencia cardíaca. Rev. Cub. Cardiol Cir Cardiovas. 2020 [acceso: 10/09/2021];26(2):1-7. Disponible en: http://www.revcardiologia.sld.cu/index.php/revcardiologia/article/view/923/pdf7.

  8. Gustafsson F, Kragelund CB, Torp Pedersen C, Seibaek M, Burchardt H, Akkan D, et al. Effect of obesity and being overweight on long-term mortality in congestive heart failure: influence of left ventricular systolic function. Eur Heart J. 2005;(26):58-64.

  9. Padwal R, McAlister FA, McMurray JJ, Cowie MR, Rich M, Pocock S, et al. The obesity paradox in heart failure patients with preserved versus reduced ejection fraction: a meta-analysis of individual patient data. Int. J Obes. Lond. 2014;38:1110-4. DOI: 10.1038/ijo.2013.203.

  10. Hong S, Lee JH, Kim KM, Lee JW, Youn YJ, Ahn MS, et al. Is there a sex-related difference in the obesity paradox in systolic heart failure? Sex-related difference in the obesity paradox. Yonsei Med. J. 2018;59:57-62. DOI: 10.3349/ymj.2018.59.1.57

  11. Favini A, Belziti C, Garagoli F, Chiabrando JG, Barbagelata l, Denes J, et al. La paradoja de la obesidad en la insuficiencia cardíaca en ancianos. Rev. Argent. Cardiol. 2021;89:211-216. DOI: org/10.7775/rac.es.v89.i3.20233

  12. Afshin A, Forouzanfar MH, Reitsma MB, Sur P, Estep K, Lee A, et al. Health Effects of Overweight and Obesity in 195 Countries over 25 Years. N Engl J Med. 2017;377:13-27. https://doi.org/10.1056/NEJMoa161436212.

  13. García Rosa ML, Chung Kang H, Lagoeiro Jorge AJ, Noel Ximenes T, Salim Sautter L, Bazon DeVito S, et al. Papel del tejido adiposo en la obesidad y en la insuficiencia cardíaca. Insuf. Card. 2019 [acceso: 10/09/2021];14(2):55-63. Disponible en: http://www.insuficienciacardiaca.org/pdf/v14n2_19/v14n2a3.pdf13.




2020     |     www.medigraphic.com