Effect of Obesity on the Prognostic Impact of Atrial Fibrillation in Heart Failure With Preserved Ejection Fraction

Yagawa, Mayuko; Nagatomo, Yuji; Izumi, Yuki; Mahara, Keitaro; Tomoike, Hitonobu; Kohno, Takashi; Mizuno, Atsushi; Goda, Ayumi; Kohsaka, Shun; Yoshikawa, Tsutomu

doi:10.1253/circj.cj-16-1130

Cited by 18 publications

(9 citation statements)

References 47 publications

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“…In the Japanese HF population, the proportion of overweight patients (BMI ≥ 25 kg/m 2 ) was reported to be 27%. 20 In the present study, however, the proportion of overweight or obese patients was only 16%. This difference in the proportion of overweight or obese patients was probably because the patients who participated in our study were more elderly.…”

Section: Discussioncontrasting

confidence: 71%

Clinical characteristics and frailty status in heart failure with preserved vs. reduced ejection fraction

et al. 2022

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Aims The aim of this study was to elucidate the clinical characteristics, including frailty status, of patients with heart failure with preserved ejection fraction (HFpEF) in comparison with those in patients with heart failure with reduced ejection fraction (HFrEF) in a super‐aged region of Japan. Methods and results Of the 1061 Japanese patients enrolled in the Kochi YOSACOI study, a multicentre registry, we divided 645 patients (median age of 81 years [interquartile range, 72–87 years]; women, 49.1%) into two groups, HFpEF patients (61.2%) and HFrEF patients (38.8%). Physical frailty was diagnosed on the basis of the Japanese version of Cardiovascular Health (J‐CHS) Study criteria. Patients for whom left ventricular ejection fraction data were not available (n = 19), patients with heart failure with mildly reduced ejection fraction (n = 172), and patients who were not assessed by the J‐CHS criteria (n = 225) were excluded. The median ages of the HFpEF and HFrEF patients were 84 and 76 years, respectively. The proportion of patients with HFpEF gradually increased with advance of age. The proportion of patients with three or more comorbidities was larger in HFpEF patients than in HFrEF patients (77.9% vs. 65.6%, P = 0.003). Handgrip strength was significantly lower in HFpEF patients than in HFrEF patients for both men (P < 0.001) and women (P = 0.041). Comfortable 5 m walking speed was significantly slower in HFpEF patients than in HFrEF patients (P < 0.001). The proportions of patients with physical frailty were 55.2% in HFpEF patients and 46.8% in HFrEF patients, and the proportion was significantly higher in HFpEF patients (P = 0.043). In multivariate analysis, physical frailty was associated with advanced age [odds ratio (OR), 1.030; 95% confidence interval (CI), 1.010–1.050; P = 0.023] and low albumin level (OR, 0.334; 95% CI, 0.192–0.582; P < 0.001) in HFpEF patients, and physical frailty was associated with women (OR, 2.150; 95% CI, 1.030–4.500; P = 0.042) and anaemia (OR, 2.840; 95% CI, 1.300–6.230; P = 0.003) in HFrEF patients. Conclusions In a super‐aged population of HF patients in Japan, HFpEF patients are more likely to be frail/have a high frailty status compared with HFrEF patients. The results suggested that physical frailty is associated with extracardiac factors in both HFpEF patients and HFrEF patients.

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Section: Discussioncontrasting

confidence: 71%

Clinical characteristics and frailty status in heart failure with preserved vs. reduced ejection fraction

et al. 2022

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“…However, studies show that obese heart failure patients with AF have a significantly lower risk of all-cause mortality and rehospitalization for worsening heart failure compared to normal weight patients. 29 In our study, AF was an independent predictor of log NT-proBNP. In patients with heart failure and AF, BNP is mainly produced in the atrium, although there are fewer myocardial cells.…”

Section: Dovepresssupporting

confidence: 50%

<p>Profile of Obesity and Comorbidities in Elderly Patients with Heart Failure</p>

Dădârlat-Pop¹,

Sitar-Tăut²,

Zdrenghea³

et al. 2020

CIA

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Background and Purpose: In Romania, robust data about the prevalence of obesity and heart failure are lacking, especially in the elderly; therefore, this study aims to analyze the profile of overweight and obese patients aged >65 years admitted to a Romanian hospital for worsening heart failure, and also their risk in the presence of comorbidities. Patients and Methods: This cross-sectional study was conducted in 126 consecutive elderly patients with overweight and obesity admitted to a Romanian hospital for worsening heart failure. They were divided into three groups: with reduced (<40%)-HFrEF, mid-range (40-49%)-HFmrEF and preserved (≥50%) ejection fraction-HFpEF. Obesity was defined according to the body mass index (BMI) status: obesity, ≥30 kg/m 2 ; overweight, 25-29.9 kg/ m 2. The Charlson Comorbidity Index (CCI) was calculated to evaluate the severity of comorbidity, with a score ranging from 2 (only heart failure present and age >65 years) to 30 (extensive comorbidity). Results: NT-proBNP values are negatively correlated with BMI only in patients with HFpEF. Creatinine clearance (p=0.0166), the presence of atrial fibrillation (p=0.0095) and NYHA functional class were independent predictors of increased NT-proBNP values. CCI score is negatively correlated with NT-proBNP values in patients with HFmrEF (r= −0.448, p=0.009) and HFpEF (r= −0.273, p=0.043). The CCI risk was not significantly different between the three groups. Conclusion: Elderly heart failure patients with overweight or obesity have particular characteristics in terms of NT-proBNP values and presence of comorbidities. In the studied population, NT-proBNP levels were strongly influenced by renal function, NYHA functional class, the presence of atrial fibrillation and left ventricular ejection fraction.

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“…Significant correlations were found between NT-pro BNP and parameters such as mitral regurgitation velocity, aortic regurgitation end-diastolic velocity, The prevalence of AF in patients with HF is less than 10% in the NYHA class 1 HF patients, while it increases up to 50% as the NYHA functional capacity worsens [17]. Multi-center studies [18,19] of HF with preserved EF reported an increased incidence of AF. In this study, in which the NYHA functional capacity was 3 (2-4), we detected PAF in approximately half of the patients.…”

Section: Discussionmentioning

confidence: 95%

Can development of atrial fibrillation in patients with ischemic heart failure with low ejection fraction be predicted?

Alpsoy

Erselcan²,

Akyüz

et al. 2019

North Clin Istanbul

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Effect of Obesity on the Prognostic Impact of Atrial Fibrillation in Heart Failure With Preserved Ejection Fraction

Cited by 18 publications

References 47 publications

Clinical characteristics and frailty status in heart failure with preserved vs. reduced ejection fraction

Clinical characteristics and frailty status in heart failure with preserved vs. reduced ejection fraction

<p>Profile of Obesity and Comorbidities in Elderly Patients with Heart Failure</p>

Can development of atrial fibrillation in patients with ischemic heart failure with low ejection fraction be predicted?

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