Obesity paradox in pulmonary hypertension due to left ventricular systolic dysfunction. 2021

Li Wang, and Liang-Ping Zhao, and Yuqi Chen, and Xiansong Chang, and Fulu Jin, and Xiang Liu
Department of Cardiology, The Second Affiliated Hospital of Soochow University, No 1055, Sanxiang Road, 215004, Suzhou City, China.

OBJECTIVE Pulmonary hypertension (PH) due to left ventricular systolic dysfunction (PH-HFrEF) is a common heart disease with poor prognosis. In this study, we explored the risk factors for PH-HFrEF and investigated the related factors affecting the prognosis of PH-HFrEF patients. METHODS The study recruited consecutive patients with PH-HFrEF and systolic pulmonary artery pressure (sPAP) of more than 40 mm Hg with left ventricular ejection fraction (LVEF) of less than 45% on echocardiography. Patients with left ventricular systolic dysfunction (HFrEF) but without PH (sPAP < 30 mmHg and LVEF < 45%) were chosen as the control group. Patients were followed up for 18 months, and major adverse cardiac events (MACE) were recorded. RESULTS In total, 93 patients with PH-HFrEF formed the study group and 93 LVEF-matched patients with HFrEF were enrolled as controls. Body mass index (BMI) in PH-HFrEF patients was significantly lower compared with the control group (p < 0.05). Multivariate logistic regression analysis revealed that low BMI was an independent predictor of the presence of PH in patients with HFrEF (p < 0.05). There were 23 (24.7%) MACE in the PH-HFrEF group and 18 (19.4%) MACE in the control group. Cox regression analysis showed that low BMI was an independent predictor of MACE occurrence in the PH-HFrEF group (p < 0.05). CONCLUSIONS Low BMI appear to be significantly associated with PH occurrence in patients with HFrEF, and is an independent predictor of MACE in patients with PH-HFrEF.

UI MeSH Term Description Entries
D006976 Hypertension, Pulmonary Increased VASCULAR RESISTANCE in the PULMONARY CIRCULATION, usually secondary to HEART DISEASES or LUNG DISEASES. Pulmonary Hypertension
D009765 Obesity A status with BODY WEIGHT that is grossly above the recommended standards, usually due to accumulation of excess FATS in the body. The standards may vary with age, sex, genetic or cultural background. In the BODY MASS INDEX, a BMI greater than 30.0 kg/m2 is considered obese, and a BMI greater than 40.0 kg/m2 is considered morbidly obese (MORBID OBESITY).
D011379 Prognosis A prediction of the probable outcome of a disease based on a individual's condition and the usual course of the disease as seen in similar situations. Prognostic Factor,Prognostic Factors,Factor, Prognostic,Factors, Prognostic,Prognoses
D006333 Heart Failure A heterogeneous condition in which the heart is unable to pump out sufficient blood to meet the metabolic need of the body. Heart failure can be caused by structural defects, functional abnormalities (VENTRICULAR DYSFUNCTION), or a sudden overload beyond its capacity. Chronic heart failure is more common than acute heart failure which results from sudden insult to cardiac function, such as MYOCARDIAL INFARCTION. Cardiac Failure,Heart Decompensation,Congestive Heart Failure,Heart Failure, Congestive,Heart Failure, Left-Sided,Heart Failure, Right-Sided,Left-Sided Heart Failure,Myocardial Failure,Right-Sided Heart Failure,Decompensation, Heart,Heart Failure, Left Sided,Heart Failure, Right Sided,Left Sided Heart Failure,Right Sided Heart Failure
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013318 Stroke Volume The amount of BLOOD pumped out of the HEART per beat, not to be confused with cardiac output (volume/time). It is calculated as the difference between the end-diastolic volume and the end-systolic volume. Ventricular Ejection Fraction,Ventricular End-Diastolic Volume,Ventricular End-Systolic Volume,Ejection Fraction, Ventricular,Ejection Fractions, Ventricular,End-Diastolic Volume, Ventricular,End-Diastolic Volumes, Ventricular,End-Systolic Volume, Ventricular,End-Systolic Volumes, Ventricular,Fraction, Ventricular Ejection,Fractions, Ventricular Ejection,Stroke Volumes,Ventricular Ejection Fractions,Ventricular End Diastolic Volume,Ventricular End Systolic Volume,Ventricular End-Diastolic Volumes,Ventricular End-Systolic Volumes,Volume, Stroke,Volume, Ventricular End-Diastolic,Volume, Ventricular End-Systolic,Volumes, Stroke,Volumes, Ventricular End-Diastolic,Volumes, Ventricular End-Systolic
D016277 Ventricular Function, Left The hemodynamic and electrophysiological action of the left HEART VENTRICLE. Its measurement is an important aspect of the clinical evaluation of patients with heart disease to determine the effects of the disease on cardiac performance. Left Ventricular Function,Function, Left Ventricular,Functions, Left Ventricular,Left Ventricular Functions,Ventricular Functions, Left
D018487 Ventricular Dysfunction, Left A condition in which the LEFT VENTRICLE of the heart was functionally impaired. This condition usually leads to HEART FAILURE; MYOCARDIAL INFARCTION; and other cardiovascular complications. Diagnosis is made by measuring the diminished ejection fraction and a depressed level of motility of the left ventricular wall. LV Diastolic Dysfunction,LV Dysfunction,LV Systolic Dysfunction,Left Ventricular Diastolic Dysfunction,Left Ventricular Dysfunction,Left Ventricular Systolic Dysfunction,Diastolic Dysfunction, LV,Dysfunction, LV,Dysfunction, LV Diastolic,Dysfunction, LV Systolic,Dysfunction, Left Ventricular,LV Diastolic Dysfunctions,LV Dysfunctions,LV Systolic Dysfunctions,Left Ventricular Dysfunctions,Systolic Dysfunction, LV

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