Body mass index and all-cause mortality in heart failure patients with normal and reduced ventricular ejection fraction: a dose–response meta-analysis

Zhang, Jufen; Begley, Aine; Jackson, Ruth; Harrison, M.; Pellicori, Pierpaolo; Clark, Andrew L.; Cleland, John G.F.

doi:10.1007/s00392-018-1302-7

Cited by 66 publications

(49 citation statements)

References 63 publications

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“…However, the effects of metabolic status cannot be ignored, because obesity and unhealthy metabolic states can exist independently, which means that it is necessary to study the effects of obesity on AD in different metabolic states [10]. Our results broke the “obesity paradox” to some extent, in which overweight and obese individuals are pretending to have lower mortality in various established studies [19–21]. Therefore, the emphases on the influence of metabolic status and early management of high BMI elder individuals with metabolic abnormalities may be beneficial in the prevention of AD events.…”

Section: Discussionmentioning

confidence: 81%

Metabolically healthy obesity reduces the risk of Alzheimer’s disease in elders: a longitudinal study

Huang

Wang

et al. 2019

Aging

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A subgroup of overweight/obese individuals, who had favorable metabolic profiles, was termed as metabolically healthy overweight/obese (MHO). Several studies suggested that MHO individuals were not at increased risk of cardiovascular disease and all-course mortality. However, whether MHO is associated with excess risk of Alzheimer’s disease (AD) in elders remains unclear. To explore the risk of AD among MHO phenotype and investigate whether MHO associates with neurodegenerative biomarkers of AD, we assessed body mass index-metabolic status phenotypes of 1199 longitudinal elders from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) cohort using the Adult Treatment Panel-III (ATP- III) criteria. MHO subjects were at a significantly decreased risk for AD (adjusted HR=0.73, 95% CI: 0.54-0.97) compared with metabolically healthy normal weight (MHNW) subjects. In multivariable linear regression models, the cross-sectional associations of MHO with cerebrospinal fluid (CSF) biomarkers, brain Aβ load, and cortical structure were explored. MHO was positively correlated with CSF-Aβ (β=0.746, P=0.015), hippocampal volume (β=0.181, P=0.011), and whole brain volume (β=0.133, P=0.004). The MHO phenotype of the elder conferred a decreased risk of AD and its role may be driven by Aβ.

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Section: Discussionmentioning

confidence: 81%

Metabolically healthy obesity reduces the risk of Alzheimer’s disease in elders: a longitudinal study

Huang

Wang

et al. 2019

Aging

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“…For patients with HFpEF, the relationship between BMI and mortality is U-shaped. This means that mortality increases significantly if the BMI lies above or below a specific range 12. HFpEF and AF share epidemiology, pathophysiology, pathogenesis and risk factors 13.…”

Section: Discussionmentioning

confidence: 99%

H2FPEF score predicts 1-year rehospitalisation of patients with heart failure with preserved ejection fraction

Tao

Wang

Zhu

et al. 2020

Postgraduate Medical Journal

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BackgroundHeart failure with preserved ejection fraction (HFpEF) has received widespread attention in recent years. There is currently a lack of valuable predictors for the prognosis of this disease. Here, we aimed to identify a non-invasive scoring system that can effectively predict 1-year rehospitalisation for patients with HFpEF.MethodsWe included 151 consecutive patients with HFpEF in a prospective cohort study and investigated the association between H2FPEF score and 1-year readmission for heart failure using multivariate Cox regression analysis.ResultsOur findings indicated that obesity, age >70 years, treatment with ≥2 antihypertensives, echocardiographic E/e’ ratio >9 and pulmonary artery pressure >35 mm Hg were independent predictors of 1-year readmission. Three models (support vector machine, decision tree in R and Cox regression analysis) proved that H2FPEF score could effectively predict 1-year readmission for patients with HFpEF (area under the curve, 0.910, 0.899 and 0.771, respectively; p<0.001).ConclusionOur study demonstrates that the H2FPEF score has excellent predictive value for 1-year rehospitalisation of patients with HFpEF.

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“…Several studies have reported different profiles in patients with HFrEF and HFpEF [6–9]. Higher average age and body mass index (BMI), more women, higher prevalence rates of atrial fibrillation and lower of ischemic heart disease (IHD) are common characteristics of the HFpEF group.…”

Section: Introductionmentioning

confidence: 99%

Non-cardiac comorbidities and mortality in patients with heart failure with reduced vs. preserved ejection fraction: a study using the Swedish Heart Failure Registry

et al. 2019

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Background Heart failure (HF) and non-cardiac comorbidities often coexist and are known to have an adverse effect on outcome. However, the prevalence and prognostic impact of non-cardiac comorbidities in patients with HF with reduced ejection fraction (HFrEF) vs. those with preserved (HFpEF) remain inadequately studied. Methods and results We used data from the Swedish Heart Failure Registry from 2000 to 2012. HFrEF was defined as EF < 50% and HFpEF as EF ≥ 50%. Of 31 344 patients available for analysis, 79.3% ( n = 24 856) had HFrEF and 20.7% ( n = 6 488) HFpEF. The outcome was all-cause mortality. We examined the association between ten non-cardiac comorbidities and mortality and its interaction with EF using adjusted hazard ratio (HR). Stroke, anemia, gout and cancer had a similar impact on mortality in both phenotypes, whereas diabetes (HR 1.57, 95% confidence interval [CI] [1.50–1.65] vs. HR 1.39 95% CI [1.27–1.51], p = 0.0002), renal failure (HR 1.65, 95% CI [1.57–1.73] vs. HR 1.44, 95% CI [1.32–1.57], p = 0.003) and liver disease (HR 2.13, 95% CI [1.83–2.47] vs. HR 1.42, 95% CI [1.09–1.85] p = 0.02) had a higher impact in the HFrEF patients. Moreover, pulmonary disease (HR 1.46, 95% CI [1.40–1.53] vs. HR 1.66 95% CI [1.54–1.80], p = 0.007) was more prominent in the HFpEF patients. Sleep apnea was not associated with worse prognosis in either group. No significant variation was found in the impact over the 12-year study period. Conclusions Non-cardiac comorbidities contribute significantly but differently to mortality, both in HFrEF and HFpEF. No significant variation was found in the impact over the 12-year study period. These results emphasize the importance of including the management of comorbidities as a part of a standardized heart failure care in both HF phenotypes.

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Body mass index and all-cause mortality in heart failure patients with normal and reduced ventricular ejection fraction: a dose–response meta-analysis

Abstract: For patients with heart failure, the relation between BMI and mortality is U-shaped with a similar nadir of risk for HFpEF and HFrEF at a BMI of 32-33 kg/m. Whether interventions that alter weight in either direction can alter risk is unknown.

Cited by 66 publications

References 63 publications

Metabolically healthy obesity reduces the risk of Alzheimer’s disease in elders: a longitudinal study

Metabolically healthy obesity reduces the risk of Alzheimer’s disease in elders: a longitudinal study

H2FPEF score predicts 1-year rehospitalisation of patients with heart failure with preserved ejection fraction

Non-cardiac comorbidities and mortality in patients with heart failure with reduced vs. preserved ejection fraction: a study using the Swedish Heart Failure Registry

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