Journal ArticleDOI
Disparate effects of left ventricular geometry and obesity on mortality in patients with preserved left ventricular ejection fraction.
Carl J. Lavie,Richard V. Milani,Hector O. Ventura,Gustavo A. Cardenas,Mandeep R. Mehra,Franz H. Messerli +5 more
TLDR
In this article, the authors evaluated 30,920 patients with preserved ejection fraction, including 11,792 obese patients and 19,128 nonobese patients to determine the impact of 4 LV geometric patterns, including normal structure, concentric remodeling (CR), as well as eccentric or concentric hypertrophy and obesity on mortality during an average followup of 3.2 ± 1.4 years.Abstract:
Left ventricular (LV) geometry predicts cardiovascular events. Although obesity is a risk factor for cardiovascular diseases, studies have noted a paradox regarding obesity and prognosis. To our knowledge no studies have determined the impact of obesity on LV geometry as well as mortality in patients with preserved ejection fraction. We evaluated 30,920 patients with preserved ejection fraction, including 11,792 obese patients as well as 19,128 nonobese patients to determine the impact of 4 LV geometric patterns, including normal structure, concentric remodeling (CR), as well as eccentric or concentric hypertrophy and obesity on mortality during an average follow-up of 3.2 ± 1.4 years. Abnormal LV geometry occurred more commonly in obese than nonobese patients (49% vs 44%, p <0.0001 for the difference in the 4 patterns). In obese patients, CR was the most prevalent abnormal pattern (34%), with eccentric and concentric LV hypertrophy occurring in 7% and 8%, respectively, compared with nonobese patients (32%, 6%, and 6%, respectively). Overall mortality was considerably lower in obese than nonobese (3.9% vs 6.5%, p <0.0001). In both groups, progressive increases in mortality compared with normal structure occurred with CR, eccentric and concentric LV hypertrophy (obese patients 2.8%, 4.8%, 5.3%, and 6.9%, respectively; and nonobese patients 4.3%, 8.4%, 9.6%, and 11.8%, respectively). In conclusion, although an obesity paradox exists, in that obesity is associated with higher prevalence of structural abnormalities but lower mortality than in nonobese patients, our data demonstrate that LV geometric abnormalities are prevalent in both obese and nonobese patients with normal ejection fraction and are associated with progressive increases in mortality.read more
Citations
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Journal ArticleDOI
Obesity and cardiovascular disease: risk factor, paradox, and impact of weight loss.
TL;DR: The adverse effects of obesity on CV disease risk factors and its role in the pathogenesis of various CV diseases are summarized, the obesity paradox and potential explanations for these puzzling data are reviewed, and a discussion regarding the current state of weight reduction in the prevention and treatment of CV diseases is discussed.
Journal ArticleDOI
Obesity and cardiovascular disease: revisiting an old relationship
TL;DR: The present narrative review summarizes the major pathophysiological links between obesity and CVD (traditional and novel concepts), analyses the heterogeneity of obesity-related cardiometabolic consequences, and provides an overview of the cardiovascular impact of weight loss interventions.
Journal ArticleDOI
Physical activity, cardiorespiratory fitness, and exercise training in primary and secondary coronary prevention.
Damon L. Swift,Carl J. Lavie,Carl J. Lavie,Neil M. Johannsen,Ross Arena,Conrad P. Earnest,Conrad P. Earnest,James H. O'Keefe,Richard V. Milani,Steven N. Blair,Timothy S. Church +10 more
TL;DR: Data from epidemiological and prospective ET studies supporting the favorable impact of PA, ET, and CRF in primary CHD prevention strongly support the routine referral of patients with CHD to CRET programs and that patients should be vigorously encouraged to attend CRET following major CHD events.
Journal ArticleDOI
The Obesity Paradox, Weight Loss, and Coronary Disease
TL;DR: Although an "obesity paradox" exists using either baseline BMI or baseline percent fat criteria, these results support the safety and potential long-term benefits of purposeful weight loss in overweight and obese patients with coronary heart disease.
Journal ArticleDOI
Impact of Cardiorespiratory Fitness on the Obesity Paradox in Patients With Heart Failure
Carl J. Lavie,Lawrence P. Cahalin,Paul Chase,Jonathan Myers,Jonathan Myers,Daniel Bensimhon,Mary Ann Peberdy,Euan A. Ashley,Erin West,Daniel E. Forman,Marco Guazzi,Ross Arena +11 more
TL;DR: It is indicated that FIT modifies the relationship between BMI and survival, and assessing the obesity paradox in systolic HF may be misleading unless FIT is considered.
References
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Roberto M. Lang,Michelle Bierig,Richard B. Devereux,Frank A. Flachskampf,Elyse Foster,Patricia A. Pellikka,Michael H. Picard,Mary J. Roman,James B. Seward,Jack S. Shanewise,Scott D. Solomon,Kirk T. Spencer,Martin St. John Sutton,William J. Stewart +13 more
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Journal ArticleDOI
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Richard B. Devereux,Richard B. Devereux,Daniel R. Alonso,Daniel R. Alonso,Elizabeth M. Lutas,Elizabeth M. Lutas,Geoffrey J. Gottlieb,Geoffrey J. Gottlieb,E Campo,E Campo,Irene Sachs,Irene Sachs,Nathaniel Reichek,Nathaniel Reichek +13 more
TL;DR: To determine the accuracy of echocardiographic left ventricular (LV) dimension and mass measurements for detection and quantification of LV hypertrophy, results of blindly read antemortem e chocardiograms were compared with LV mass measurements made at necropsy in 55 patients.
Journal ArticleDOI
Prognostic Implications of Echocardiographically Determined Left Ventricular Mass in the Framingham Heart Study
TL;DR: The estimation of left ventricular mass by echocardiography offers prognostic information beyond that provided by the evaluation of traditional cardiovascular risk factors, and it is concluded that an increase in left Ventricular mass predicts a higher incidence of clinical events, including death, attributable to cardiovascular disease.
Journal ArticleDOI
Obesity as an independent risk factor for cardiovascular disease: a 26-year follow-up of participants in the Framingham Heart Study.
TL;DR: Intervention in obesity, in addition to the well established risk factors, appears to be an advisable goal in the primary prevention of CVD.