Abstract 10807: Intentional Weight Loss is Associated With a Significant Improvement in Ejection Fraction in Obese Heart Failure.

Introduction: Obesity and heart failure with reduced ejection fraction (HFrEF) commonly coexist. However, the parallel observations that obesity is associated with improved survival in HFrEF, and that unintentional weight loss is a poor prognostic sign, are conflicting. Therefore, evidence is lacking regarding the role of intentional weight loss in HFrEF. In this study, we sought to investigate the impact of intentional weight loss in obese HFrEF on metabolic status, cardiac function and exercise capacity. Methods: 37 patients with stable idiopathic dilated cardiomyopathy (BMI 35±5kg/m2, LVEF 41±8%), and 23 matched controls (BMI 35±5kg/m2, LVEF 65±4%) underwent body composition analysis, quantification of abdominal visceral and hepatic fat, cardiac MR for geometry and systolic function, cardiopulmonary exercise testing and six minute walk test. All undertook a 12 month dietary intervention (1500kcal/day) before reassessment. Results: In obese controls, weight loss (-10±8%) led to a reduction in LV end diastolic volume (EDV by 6±4%, p=0.001) and LV mass (by 12±7%, p=0.001). In HFrEF, intentional weight loss (-7±6%) also led to reductions in LV EDV (by 8±10%, p=0.010), and LV mass (by 6±9%, p=0.047) and a significant improvement in LV systolic function (absolute LVEF +8±6%, p<0.001, figure 1 and table). Exercise capacity in HFrEF was maintained in weight loss (six minute walk test distance increase by 28±37m, p=0.057). Conclusion: Here we demonstrate in a prospective study that intentional weight loss is associated with substantial improvements in LV systolic function and prevents decline in exercise capacity. This suggests that weight loss may be an effective therapeutic strategy in HFrEF. [ABSTRACT FROM AUTHOR]