Interventional Medicine and Applied Science
Volume/Issue:
Volume 2: Issue 1
Correlation of body mass index and responder status in heart failure patients after cardiac resynchronization therapy: Does the obesity paradox exist?
Authors:
Marcell Clemens Department of Cardiology, University of Debrecen, Debrecen, Hungary
Department of Cardiology, University of Debrecen, Móricz Zs. krt. 22, H-4032, Debrecen, Hungary

Search for other papers by Marcell Clemens in
Current site
Google Scholar
PubMed Close
,
E. Nagy-Baló Department of Cardiology, University of Debrecen, Debrecen, Hungary

Search for other papers by E. Nagy-Baló in
Current site
Google Scholar
PubMed Close
,
Cs. Herczku Department of Cardiology, University of Debrecen, Debrecen, Hungary

Search for other papers by Cs. Herczku in
Current site
Google Scholar
PubMed Close
,
Zs. Karányi Department of Internal Medicine, University of Debrecen, Debrecen, Hungary

Search for other papers by Zs. Karányi in
Current site
Google Scholar
PubMed Close
,
I. Édes Department of Cardiology, University of Debrecen, Debrecen, Hungary

Search for other papers by I. Édes in
Current site
Google Scholar
PubMed Close
, and
Z. Csanádi Department of Cardiology, University of Debrecen, Debrecen, Hungary

Search for other papers by Z. Csanádi in
Current site
Google Scholar
PubMed Close
Pages:
17–21
Online Publication Date:
01 Mar 2010
Publication Date:
01 Mar 2010
Article Category:
Research Article
DOI:
https://doi.org/10.1556/imas.2.2010.1.4
Keywords:
cardiac resynchronization therapy; body mass index; obesity paradox; dilated cardiomyopathy; responder status
Restricted access

Abstract

Aims: We investigated the influence of body mass index (BMI) on the prevalence of responder status in chronic heart failure patients after cardiac resynchronization therapy (CRT).

Methods: Data on 169 patients with resynchronization therapy were analyzed. Patients were categorized on the basis of the BMI measured at device implantation according to the WHO classification, as normal (BMI: 18.5–24.9 kg/m2), overweight (BMI: 25–29.9 kg/m2) or obese (BMI:≥30 kg/m2). Patients were considered responders if left ventricular ejection fraction was increased by at least 5% at 6-month follow-up.

Results: The mean age in the study population was 60.9±10.86 years (females 29%). The BMI subgroups did not exhibit any significant differences in baseline characteristics (age, gender, left ventricular ejection fraction or NYHA class). Elevated BMIs were associated with higher prevalence of responder status (overweight: 71.4%, obese: 63.0%) relative to subjects with a normal BMI (44.7%) (p=0.015).

Conclusions: In this CRT population, overweight status was associated with a more favorable response to CRT, indicating that the response may possibly be influenced by factors other than those directly related to the heart status or the technical details of the CRT.

  • 1. D.H. Birnie A.S.L. Tang 2006 The problem of non-response to cardiac resynchronization therapy Curr Opin Cardiol 21 20 26.

  • 2. N. Freemantle P. Tharmanathan M.J. Calvert W.T. Abraham J. Ghosh J.G.F. Cleland 2006 Cardiac resynchronisation for patients with heart failure due to left ventricular systolic dysfunction — A systematic review and meta-analysis Eur J Heart Fail 8 433 440.

    • Search Google Scholar
    • Export Citation

  • 3. E.S. Chung A.R. Leon L. Tavazzi et al.2008 Results of the predictors of response to CRT (PROSPECT) trial Circulation 117 2608 2616.

  • 4. S.A. Mollema G. Bleeker E. van der Wall M. Schalij J. Bax 2007 Usefulness of QRS duration to predict response to predict response to cardiac resynchronization therapy in patients with end-stage heart failure Am J Cardiol 100 1665 1670.

    • Search Google Scholar
    • Export Citation

  • 5. M. Gasparini M. Mantica P. Galimberti et al.2003 Is the left ventricular lateral wall the best lead implantation site for cardiac resynchronization therapy Pacing Clin Electrophysiol 26 1Pt2 162 168.

    • Search Google Scholar
    • Export Citation

  • 6. M. Haghjoo H.R. Bonakdar M.V. Jorat et al.2009 Effect of right ventricular lead location on response to cardiac resynchronization therapy in patients with end-stage heart failure Europace 11 356 363.

    • Search Google Scholar
    • Export Citation

  • 7. C. D'Ivernois J. Lesage P. Blanc 2008 Resynchronization: What if the left ventricular lead cannot reach the lateral or posterolateral wall? Pacing Clin Electrophysiol 31 1041 1045.

    • Search Google Scholar
    • Export Citation

  • 8. A. Achilli C. Peraldo M. Sassara et al.2006 Prediction of response to cardiac resynchronization therapy: The selection of candidates for CRT (SCART) study Pacing Clin Electrophysiol 29 Suppl2 S11 S19.

    • Search Google Scholar
    • Export Citation

  • 9. S.G. Molhoek J. Bax L. van Erven et al.2004 Comparison of benefits from cardiac resynchronization therapy in patients with ischemic cardiomyopathy versus idiopathic dilated cardiomyopathy Am J Cardiol 93 860 863.

    • Search Google Scholar
    • Export Citation

  • 10. World Health Organization: Global database of body mass index. Available at: http://www.who.int/bmi/index.jsp. Accessed January 20, 2009.

    • Search Google Scholar
    • Export Citation

  • 11. R.M. Krauss M. Winston 1998 Obesity: Impact on cardiovascular disease Circulation 98 1472 1476.

  • 12. S. Kenchaiah J.C. Evans D. Levy et al.2002 Obesity and the risk of heart failure N Engl J Med 347 305 313.

  • 13. P. Poirier T.D. Giles G.A. Bray et al.2006 Obesity and cardiovascular disease: Pathophysiology, evaluation, and effect of weight loss: an update of the 1997 American Heart Association Scientific Statement on Obesity and Heart Disease from the obesity committee of the Council of Nutrition, Physical Activity, and Metabolism Circulation 113 898 918.

    • Search Google Scholar
    • Export Citation

  • 14. O. Divitiis S. Fazio M. Petitto et al.1981 Obesity and cardiac function Circulation 64 477 482.

  • 15. M.A. Alpert B.E. Terry M. Mulekar et al.1997 Cardiac morphology and left ventricular function in normotensive morbidly obesee patients with and without congestive heart failure, and effect of weight loss Am J Cardiol 80 736 740.

    • Search Google Scholar
    • Export Citation

  • 16. J.P. Curtis J.G. Selter Y. Wang et al.2005 The obesity paradox body mass index and outcomes in patients with heart failure Arch InternMed 165 55 61.

    • Search Google Scholar
    • Export Citation

  • 17. B. Bozkurt A. Deswal 2005 Obesity as a prognostic factor in chronic symptomatic heart failure Am Heart J 150 1233 1239.

  • 18. C.H. Davos W. Doehner M. Rauchhaus et al.2003 Body mass and survival in patients with chronic heart failure without cachexia: The importance of obesity J Card Fail 91 891 894.

    • Search Google Scholar
    • Export Citation

  • 19. G.C. Fonarow P. Srikanthan M.R. Costanzo et al.2007 An obesity paradox in acute heart failure: analysis of body mass index and inhospital mortality for 108,927 patients in the Acute Decompensated Heart Failure National Registry Am Heart J 153 74 81.

    • Search Google Scholar
    • Export Citation

  • 20. C. Schernthaner M. Pichler B. Strohmer 2007 Lower body mass index and atrial fibrillation as independent predictors for mortality in patients with implantable cardioverter defibrillator Croat Med J 48 59 67.

    • Search Google Scholar
    • Export Citation

  • 21. J. Cleland N. Freemantle S. Ghio et al.2008 Predicting the long-term effects of cardiac resynchronization therapy on mortality from baseline variables and the early response. A report from the CARE-HF (Cardiac Resynchronization in Heart Failure) Trial J Am Coll Cardiol 52 438 445.

    • Search Google Scholar
    • Export Citation

  • 22. C.M. Yu B.G. Bleeker J.-H. Fung et al.2005 Left ventricular reverse remodeling but not clinical improvement predicts long-term survival after cardiac resynchronization therapy Circulation 112 1580 1586.

    • Search Google Scholar
    • Export Citation

  • 23. M. Kubanek I. Málek J. Bytesnik et al.2006 Decrease in plasma B-type natriuretic peptide early after initiation of cardiac resynchronization therapy predicts clinical improvement at 12 months Eur J Heart Fail 8 832 840.

    • Search Google Scholar
    • Export Citation

  • 24. T.B. Horwich G.C. Fonarow M.A. Hamilton et al.2001 The relationship between obesity and mortality in patients with heart failure J Am Coll Cardiol 38 789 795.

    • Search Google Scholar
    • Export Citation

  • 25. K. Kalantar-Zadeh T.B. Horwich A. Oreopoulos et al.2007 Risk factor paradox in wasting diseases Curr Opin Clin Nutr Metab Care 10 433 442.

    • Search Google Scholar
    • Export Citation

  • 26. A.J. Moss W.J. Hall D.S. Cannom et al.2009 Cardiac-resynchronization therapy for the prevention of heart-failure events N Engl J Med 361 1329 1338.

    • Search Google Scholar
    • Export Citation

  • 27. C. Daubert M.R. Gold W.T. Abraham et al.2009 Prevention of disease progression by cardiac resynchronization therapy in patients with asymptomatic or mildly symptomatic left ventricular dysfunction. Insights from the European cohort of the REVERSE (Resynchronization reverses remodeling in systolic left ventricular dysfunction) trial J Am Coll Cardiol 54 1837 1846.

    • Search Google Scholar
    • Export Citation
  • Collapse
  • Expand
Cover Interventional Medicine and Applied Science
Interventional Medicine and Applied Science
Print ISSN:
2061-1617
Online ISSN:
2061-5094

2019  
Scimago
H-index		 11
Scimago
Journal Rank		 0,220
Scimago
Quartile Score		 Medicine (miscellaneous) Q3
Scopus
Cite Score		 155/133=1,2
Scopus
Cite Score Rank		 General Medicine 199/529 (Q2)
Scopus
SNIP		 0,343
Scopus
Cites		 206
Scopus
Documents		 23

 

Interventional Medicine and Applied Science
Language English
Size  
Year of
Foundation		 2009
Publication
Programme		 changed title
Volumes
per Year		  
Issues
per Year		  
Founder Akadémiai Kiadó
Founder's
Address		 H-1117 Budapest, Hungary 1516 Budapest, PO Box 245.
Publisher Akadémiai Kiadó
Publisher's
Address		 H-1117 Budapest, Hungary 1516 Budapest, PO Box 245.
Responsible
Publisher		 Chief Executive Officer, Akadémiai Kiadó
ISSN 2061-1617 (Print)
ISSN 2061-5094 (Online)

Monthly Content Usage

Abstract Views Full Text Views PDF Downloads
Nov 2024 35 0 0
Dec 2024 13 0 0
Jan 2025 46 0 0
Feb 2025 48 0 0
Mar 2025 50 0 0
Apr 2025 11 0 0
May 2025 3 0 0