Joint Impact of Body Mass Index and Physical Capacity on Mortality in Patients With Systolic Heart Failure

Zafrir, Barak; Salman, Nabia; Amir, Offer

doi:10.1016/j.amjcard.2013.12.030

Cited by 15 publications

(14 citation statements)

References 32 publications

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“…Zafrir et al evaluated the collective impact of BMI and 6-minute walk distance (6MWD) in 543 advanced HF patients. 133 Consistent with other reports, the study showed a strong obesity paradox in the entire study population during 40 months follow-up. However, the obesity paradox disappeared in the high physical capability group, when study subjects were categorized based on 6MWD.…”

Section: Accepted Manuscriptsupporting

confidence: 92%

The Interaction of Cardiorespiratory Fitness With Obesity and the Obesity Paradox in Cardiovascular Disease

Oktay¹,

Lavie²,

Kokkinos

et al. 2017

Progress in Cardiovascular Diseases

143

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Overweight and obesity are well-established risk factors for most cardiovascular diseases (CVD), including coronary heart disease (CHD), heart failure (HF), and atrial fibrillation. Despite the strong link between excess adiposity and risk of CVD, growing evidence has demonstrated an obesity paradox in patients with CVD. This phenomenon is characterized by a better prognosis in overweight and mildly obese CVD patients than their leaner counterparts. Moreover, the worst outcomes are often incurred by underweight CVD patients, followed by those of normal weight or severely obese. The obesity paradox is now a well-established phenomenon across different types of CVD, and it occurs regardless of age and ethnicity of patients, and severity of CVD. Physical inactivity and low cardiorespiratory fitness (CRF) have long been recognized as major risk factors for CVD. In contrast, high levels of physical activity (PA) and CRF largely neutralize the adverse effects of excess adiposity and other traditional CVD risk factors, including hypertension, metabolic syndrome, and type-2 diabetes. Higher CRF also results in better CVD outcomes across different BMI groups and significantly alters the obesity paradox in patients with HF and CHD. Prognostic benefits of overweight/obesity tend to be limited to unfit patients with HF and CHD, and the obesity paradox usually disappears with improved levels of CRF. Nevertheless, increased PA and exercise training, to maintain or improve CRF, are effective, safe, and proven strategies for primary and secondary prevention of CVD in all weight groups. In this review, we discuss the current concepts of individual and combined contributions of fatness and fitness to CVD risk and prognosis. We then examine the influence of fitness on the obesity paradox in individuals with CVD.

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Section: Accepted Manuscriptsupporting

confidence: 92%

The Interaction of Cardiorespiratory Fitness With Obesity and the Obesity Paradox in Cardiovascular Disease

Oktay¹,

Lavie²,

Kokkinos

et al. 2017

Progress in Cardiovascular Diseases

143

View full text Add to dashboard Cite

show abstract

“…The potential modifiers for association between BMI and risk of all‐cause mortality were proposed, such as gender, fitness, HF causes, follow‐up period, and ethnical issue. When stratified analyses were conducted by age and HF type, the heterogeneity between studies decreased to low and moderate, respectively.…”

Section: Discussionmentioning

confidence: 99%

A U‐shaped association of body mass index and all‐cause mortality in heart failure patients: A dose‐response meta‐analysis of prospective cohort studies

Qin

Chen

2017

Cardiovascular Therapeutics

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“…A similar negative impact is also emerging in obesity despite potential difficulties in identifying and defining muscle changes within the obese phenotype [58,59,60]. Available studies indeed described muscle changes through heterogeneous definitions and methodologies including body composition analysis, muscle strength, or cardiorespiratory fitness and physical capacity [61,62,63,64]. With this limitation in mind, obese individuals with low muscle mass or functional parameters had higher risk of developing frailty and disability, and therefore poor quality of life [65,66].…”

Section: Introduction: What We Knowmentioning

confidence: 99%

Sarcopenic Obesity: Time to Meet the Challenge

et al. 2018

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The prevalence of overweight and obesity has reached epidemic proportions worldwide due to increasingly pervasive obesogenic lifestyle changes. Obesity poses unprecedented individual, social, and multidisciplinary medical challenges by increasing the risk for metabolic diseases, chronic organ failures, and cancer as well as complication rates in the presence of acute disease conditions. Whereas reducing excess adiposity remains the fundamental pathogenic treatment for obese individuals, complex metabolic and lifestyle abnormalities as well as weight reduction therapies per se may also compromise the ability to preserve muscle function and mass, especially when chronic disease co-exists with obesity. Emerging evidence indicates that low muscle mass and quality have a strong negative prognostic impact in obese individuals and may lead to frailty, disability, and increased morbidity and mortality. Awareness of the importance of skeletal muscle maintenance in obesity is however low among clinicians and scientists. The term ‘sarcopenic obesity' has been proposed to identify obesity with low skeletal muscle function and mass, but its utilization is largely limited to the aging patient population, and consensus on its definition and diagnostic criteria remains insufficient. Knowledge on prevalence of sarcopenic obesity in various clinical conditions and patient subgroups, on its clinical impacts in patient risk stratification, and on effective prevention and treatment strategies remain therefore dramatically inadequate. In particular, optimal dietary options and medical nutritional support strategies to preserve muscle mass in obese individuals remain largely undefined. The European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Association for the Study of Obesity (EASO) recognize and indicate obesity with altered body composition due to low skeletal muscle function and mass (sarcopenic obesity) as a scientific and clinical priority for researchers and clinicians. ESPEN and EASO therefore call for coordinated action aimed at reaching consensus on its definition, diagnostic criteria, and optimal treatment with particular regard to nutritional therapy. We are convinced that achievement of these goals has a strong potential to reduce the burden of morbidity and mortality in the rapidly increasing obese patient population.

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Joint Impact of Body Mass Index and Physical Capacity on Mortality in Patients With Systolic Heart Failure

Cited by 15 publications

References 32 publications

The Interaction of Cardiorespiratory Fitness With Obesity and the Obesity Paradox in Cardiovascular Disease

The Interaction of Cardiorespiratory Fitness With Obesity and the Obesity Paradox in Cardiovascular Disease

A U‐shaped association of body mass index and all‐cause mortality in heart failure patients: A dose‐response meta‐analysis of prospective cohort studies

Sarcopenic Obesity: Time to Meet the Challenge

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