CBS 2019
CBSMD教育中心
English

科学研究

科研文章

荐读文献

In-Hospital Costs and Costs of Complications of Chronic Total Occlusion Angioplasty Insights From the OPEN-CTO Registry Long-term outcomes of rotational atherectomy of underexpanded stents. A single center experience Double kissing crush in left main coronary bifurcation lesions: A crushing blow to the rival stenting techniques Chronic Kidney Disease and Coronary Artery Disease Left Ventricular Assist Devices: Synergistic Model Between Technology and Medicine Diagnostic performance of stress perfusion cardiac magnetic resonance for the detection of coronary artery disease: A systematic review and meta-analysis Drug-eluting balloons in coronary interventions: the quiet revolution? Catheterization Laboratory Considerations During the Coronavirus (COVID-19) Pandemic: From the ACC’s Interventional Council and SCAI Classification of Deaths in Cardiovascular Outcomes Trials Known Unknowns and Unknown Unknowns Ejection Fraction Pros and Cons: JACC State-of-the-Art Review

Clinical Trial2018 May 22. [Epub ahead of print]

JOURNAL:Chest. Article Link

The association between body mass index and obesity with survival in pulmonary arterial hypertension

Weatherald J, Huertas A, Boucly A et al. Keywords: body mass index; obesity; prognosis; pulmonary arterial hypertension; survival

ABSTRACT


BACKGROUNDAn obesity paradox, wherein obese patients have lower mortality, has been described in cardiopulmonary diseases, including pulmonary arterial hypertension (PAH). Our objective was to determine whether obesity and body mass index (BMI) are associated with mortality in patients with PAH.


METHODS - We assessed incident patients with idiopathic, drug-induced, and heritable PAH from the French PAH Registry. Cox regression and Kaplan-Meier analysis were used to assess the association between BMI and obesity with all-cause mortality.

RESULTS - Of 1255 patients included, 30% were obese. A higher proportion of females (65.1% vs 53.4%, p<0.01), drug-induced PAH (28.9% vs 9.2%, p<0.01), systemic hypertension, diabetes, and hypothyroidism were present in the obese group. More obese patients were in New York Heart Association class III (66.4% vs. 57.1%), fewer were class IV (11.8% vs 16.9%) (p<0.01), and 6-minute walk distance was lower (276±121 vs 324±146, p<0.01). Right atrial pressure, pulmonary wedge pressure and cardiac index were higher while pulmonary vascular resistance was lower in obese patients. Neither BMI (HR 0.99, 95%CI 0.97-1.01, p=0.41) nor obesity (HR 1.0, 95%CI 0.99-1.01, p=0.46) were associated with mortality in multivariable analyses. There was a significant interaction between age and obesity such that mortality increased among morbidly obese patients under 65 years old (HR 3.01, 95%CI 1.56-5.79, p=0.001).

CONCLUSIONS - Obesity was not associated with mortality in the overall population, but there was an age-obesity interaction with increased mortality among young morbidly obese patients. These results have implications for active weight management in younger morbidly obese patients who are otherwise candidates for lung transplantation.

Copyright © 2018. Published by Elsevier Inc.