Body Mass Index as a Predictor of Sudden Cardiac Death and Usefulness of the Electrocardiogram for Risk Stratification

Eranti, Antti; A, Aro; Kerola, Tuomas; Tikkanen, Jani T.; Rissanen, Harri; Anttonen, Olli; Junttila, M. Juhani; Knekt, Paul

doi:10.1016/j.amjcard.2015.10.057

Cited by 12 publications

(17 citation statements)

References 27 publications

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“…To date, studies are not addressed to overweight individuals, although this population also exhibit higher adverse events in long-term [7,8]. Our findings highlight that, even though they are in a lower risk zone than obese subjects, overweight individuals show anthropometric, musculoskeletal, and functional changes that should be treated by physiotherapists.…”

Section: Discussionmentioning

confidence: 89%

“…The prevalence of obesity increased from 3.2% in 1975 to 10.8% in 2014 in men, and from 6.4% to 1.9% in women [6]. Obese subjects were at increased risk for sudden cardiac death (HR 1.79) [7] and death by general cause among subjects aged 50-69 years (HR 1.14) [8]. In health-related quality of life, obesity can increase problems in mobility, self-care, and usual activities and pain/ discomfort [9].…”

Section: Introductionmentioning

confidence: 99%

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The Impact of Overweight on Flexibility and Functional Capacity

Bittencourt¹,

Vieira²,

Ferreira³

et al. 2017

J Nov Physiother

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Obesity is a health problem worldwide, with a significant impact on the mortality of individuals. However, considering the importance of preventive management, few studies have addressed the predictors of functional impairment in overweight subjects. The present study aimed to verify the differences in functional variables in overweight volunteers compared to eutrophic subjects, to determine the independent predictors of functional capacity in overweight subjects and to provide a model that can predict exercise capacity in this population. Seventy-four physically active participants (both sexes, aged 18 to 60 years) were evaluated and stratified into two groups: eutrophic (n=45, 33 ± 11 years, 76% females) and overweight (n=29, 37 ± 12 years, 41% females), according to body mass index (BMI). All volunteers were submitted to clinical, anthropometric, flexibility, muscle strength and endurance evaluation and maximal exercise testing. Differences between groups were verified by Independent T test or Mann-Whitney. Uni and multivariate linear regressions were performed to verify the independent predictors of functional capacity in the overweight group. The overweight individuals were predominantly male (58.6%), with iliopsoas (p=0.009), pectoral (p<0.001) and piriformis (p=0.003) shortening, and with lower values of peak oxygen uptake (VO 2peak ) (p=0.012). In the final multivariate model, BMI and body fat percentage were the only independent predictors of functional capacity in overweight volunteers and VO 2peak can be predicted by the model VO 2peak =85.161 -(0.747 × BMI) -(0.925 × body fat percentage). Overweight individuals already show musculoskeletal and functional changes when compared to eutrophic ones. Preventive strategies should be adopted in this population, aiming to prevent musculoskeletal and functional dysfunctions that may compromise the functional capacity of these individuals.

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Section: Discussionmentioning

confidence: 89%

Section: Introductionmentioning

confidence: 99%

The Impact of Overweight on Flexibility and Functional Capacity

Bittencourt¹,

Vieira²,

Ferreira³

et al. 2017

J Nov Physiother

View full text Add to dashboard Cite

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“…2) Does this slight structural abnormality underlie arrhythmia or SCD in SUNDS? Although epidemiological studies on the impact of body mass index to SCD risk are conflicting, 27 over 60% of chronic ischemia heart disease associated SCD were reported to have overweight hearts. 28 Cardiomegaly was identified to be the sole arrhythmogenic substrate in approximately 40% of structural heart disease related SCD without specific cardiomyopathy.…”

Section: Disscussionmentioning

confidence: 99%

Does Sudden Unexplained Nocturnal Death Syndrome Remain the Autopsy-Negative Disorder: A Gross, Microscopic, and Molecular Autopsy Investigation in Southern China

Zhang

Tester

Lang

et al. 2016

Mayo Clinic Proceedings

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Objective To look for previously unrecognized cardiac structural abnormalities and address the genetic cause for sudden unexplained nocturnal death syndrome (SUNDS). Methods and Results 148 SUNDS victims and 444 controls (matched 1:3 on gender, race, and age of death within 1 year) were collected from Sun Yat-sen University from January 1, 1998 to December 31, 2014 to search morphological changes. Additional 17 Brugada syndrome (BrS) patients collected from January 1, 2006 to December 31, 2014 served as a comparative disease cohort. The Target Captured Next Generation sequencing for 80 genes associated with arrhythmia/cardiomyopathy were performed in 44 SUNDS victims and 17 BrS patients to characterize the molecular spectrum. SUNDS had slight but statistically significantly increased heart weight and valve circumference compared to controls. 12/44 SUNDS victims (SCN5A, SCN1B, CACNB2, CACNA1C, AKAP9, KCNQ1, KCNH2, KCNJ5, GATA4, NUP155, ABCC9) and 6/17 BrS patients (SCN5A, CACNA1C, P>.05) carried rare variants in primary arrhythmia-susceptibility genes. Only 2/44 SUNDS cases compared to 5/17 BrS patients hosted a rare variant in the most common BrS causing gene, SCN5A (P=.01). Using the strict American College of Medical Genetics guideline-based definition, only 2/44 (KCNQ1) SUNDS and 3/17 (SCN5A) BrS patients hosted a “(likely) pathogenic” variant. The 14/44 SUNDS cases with cardiomyopathy-related variants had a subtle but significantly decreased circumference of cardiac valves, and tended to die on average 5–6 years younger compared to the remaining 30 cases (P=.02). Conclusions We present the first comprehensive autopsy evidence that SUNDS victims may have concealed cardiac morphological changes. SUNDS and BrS may result from different molecular pathological underpinnings. The distinct association between cardiomyopathy-related rare variants and SUNDS warrants further investigation.

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“…Recently, Eranti et al20 reported that overweight and obese patients were at increased risk for SCD in a general population of 10 543 middle‐aged subjects. Obesity itself may contribute to the development of arrhythmogenic substrates in the ventricle.…”

Section: Discussionmentioning

confidence: 99%

Body Mass Index and Sudden Cardiac Death in Japanese Patients After Acute Myocardial Infarction: Data From the JCAD Study and HIJAMI‐II Registry

Shiga

Kohro

Yamasaki

et al. 2018

JAHA

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BackgroundAlthough an “obesity paradox” exists in patients after myocardial infarction, the association between obesity and the risk of sudden cardiac death (SCD) is limited. The aim of this study was to determine whether obesity is associated with an increased risk of SCD in Japanese survivors of acute myocardial infarction.Methods and ResultsPooled data from 2 cohort studies in Japan, JCAD (Japanese Coronary Artery Disease) study and the Heart Institute of Japan Acute Myocardial Infarction‐II (HIJAMI‐II) registry, comprising of 6216 patients (mean age 65±11 years, 75.2% male) with acute myocardial infarction who were discharged alive, were studied. The patients were categorized into the following body mass index (BMI) groups at baseline according to the World Health Organization classification for Asian populations: BMI <18.5 kg/m2 (n=335), 18.5 to 23 kg/m2 (n=2371), 23 to 27.5 kg/m2 (n=2823), and ≥27.5 kg/m2 (n=687). The main outcomes were all‐cause mortality and SCD. During an average follow‐up period of 3.6±1.4 years, all‐cause mortality was 10.1%, and SCD was 1.2%. Patients with BMI <18.5 kg/m2 had the highest rate of all‐cause mortality (adjusted hazard ratio, 1.61; 95% confidence interval, 1.20–2.16), but high BMI (≥27.5 kg/m2) was not associated with mortality compared with patients in the group with BMI ≥18.5 and <23 kg/m2. However, the long‐term risk of SCD was increased in the group with BMI ≥27.5 kg/m2 (adjusted hazard ratio, 2.97; 95% confidence interval, 1.24–7.15). Multivariate analysis revealed that BMI ≥27.5 kg/m2 was associated with an increased risk of SCD (hazard ratio, 2.78; 95% confidence interval, 1.35–5.74).ConclusionsObesity (BMI ≥27.5 kg/m2) was associated with the risk of SCD in Japanese patients after myocardial infarction, although an obesity paradox was found for all‐cause mortality.

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Body Mass Index as a Predictor of Sudden Cardiac Death and Usefulness of the Electrocardiogram for Risk Stratification

Cited by 12 publications

References 27 publications

The Impact of Overweight on Flexibility and Functional Capacity

The Impact of Overweight on Flexibility and Functional Capacity

Does Sudden Unexplained Nocturnal Death Syndrome Remain the Autopsy-Negative Disorder: A Gross, Microscopic, and Molecular Autopsy Investigation in Southern China

Body Mass Index and Sudden Cardiac Death in Japanese Patients After Acute Myocardial Infarction: Data From the JCAD Study and HIJAMI‐II Registry

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