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Association of Obesity With Adverse Long-term Outcomes in Hypertrophic Cardiomyopathy
- Source :
- JAMA Cardiology, 5(1), 65-72. American Medical Association, JAMA Cardiol
- Publication Year :
- 2020
-
Abstract
- IMPORTANCE: Patients with hypertrophic cardiomyopathy (HCM) are prone to body weight increase and obesity. Whether this predisposes these individuals to long-term adverse outcomes is still unresolved. OBJECTIVE: To describe the association of body mass index (BMI, calculated as weight in kilograms divided by height in meters squared) with long-term outcomes in patients with HCM in terms of overall disease progression, heart failure symptoms, and arrhythmias. DESIGN, SETTING, AND PARTICIPANTS: In this cohort study, retrospective data were analyzed from the ongoing prospective Sarcomeric Human Cardiomyopathy Registry, an international database created by 8 high-volume HCM centers that includes more than 6000 patients who have been observed longitudinally for decades. Records from database inception up to the first quarter of 2018 were analyzed. Patients were divided into 3 groups according to BMI class (normal weight group, 30). Patients with 1 or more follow-up visits were included in the analysis. Data were analyzed from April to October 2018. EXPOSURES: Association of baseline BMI with outcome was assessed. MAIN OUTCOME AND MEASURES: Outcome was measured against overall and cardiovascular mortality, a heart failure outcome (ejection fraction less than 35%, New York Heart Association class III/IV symptoms, cardiac transplant, or assist device implantation), a ventricular arrhythmic outcome (sudden cardiac death, resuscitated cardiac arrest, or appropriate implantable cardioverter-defibrillator therapy), and an overall composite outcome (first occurrence of any component of the ventricular arrhythmic or heart failure composite end point, all-cause mortality, atrial fibrillation, or stroke). RESULTS: Of the 3282 included patients, 2019 (61.5%) were male, and the mean (SD) age at diagnosis was 47 (15) years. These patients were observed for a median (interquartile range) of 6.8 (3.3-13.3) years. There were 962 patients in the normal weight group (29.3%), 1280 patients in the preobesity group (39.0%), and 1040 patients in the obesity group (31.7%). Patients with obesity were more symptomatic (New York Heart Association class of III/IV: normal weight, 87 [9.0%]; preobesity, 138 [10.8%]; obesity, 215 [20.7%]; P
- Subjects :
- Adult
Male
medicine.medical_specialty
New York Heart Association Class
Electric Countershock
Cardiomyopathy
030204 cardiovascular system & hematology
Body Mass Index
Ventricular Outflow Obstruction
Sudden cardiac death
Cohort Studies
03 medical and health sciences
0302 clinical medicine
SDG 3 - Good Health and Well-being
Internal medicine
Atrial Fibrillation
medicine
Humans
Obesity
030212 general & internal medicine
Mortality
Original Investigation
Retrospective Studies
Heart Failure
Ejection fraction
business.industry
Hypertrophic cardiomyopathy
Arrhythmias, Cardiac
Stroke Volume
Atrial fibrillation
Cardiomyopathy, Hypertrophic
Middle Aged
medicine.disease
Defibrillators, Implantable
Heart Arrest
Stroke
Death, Sudden, Cardiac
Heart failure
Disease Progression
Heart Transplantation
Female
Heart-Assist Devices
Cardiology and Cardiovascular Medicine
business
Body mass index
Subjects
Details
- ISSN :
- 23806583
- Database :
- OpenAIRE
- Journal :
- JAMA Cardiology, 5(1), 65-72. American Medical Association, JAMA Cardiol
- Accession number :
- edsair.doi.dedup.....e4dae5941d2ce65a7bdb6446e16becd2