CBS 2019
CBSMD教育中心
English

科学研究

科研文章

荐读文献

Short-Term Progression of Multiterritorial Subclinical Atherosclerosis Long-Term Outcomes of Anticoagulation for Bioprosthetic Valve Thrombosis CT Angiographic and Plaque Predictors of Functionally Significant Coronary Disease and Outcome Using Machine Learning Increased Risk of Valvular Heart Disease in Systemic Sclerosis: An Underrecognized Cardiac Complication Circadian-Regulated Cell Death in Cardiovascular Diseases Lateral Wall Dysfunction Signals Onset of Progressive Heart Failure in Left Bundle Branch Block Incidence, predictors, and outcomes associated with acute kidney injury in patients undergoing transcatheter aortic valve replacement: from the BRAVO-3 randomized trial Diagnostic performance of noninvasive myocardial perfusion imaging using single-photon emission computed tomography, cardiac magnetic resonance, and positron emission tomography imaging for the detection of obstructive coronary artery disease: a meta-analysis Exercise Intolerance in Patients With Heart Failure: JACC State-of-the-Art Review Cardio-Oncology: How New Targeted Cancer Therapies and Precision Medicine Can Inform Cardiovascular Discovery

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.