TY - JOUR
T1 - Underweight is associated with poor prognosis in heart failure with preserved ejection fraction
AU - Matsuhiro, Yutaka
AU - Nishino, Masami
AU - Ukita, Kohei
AU - Kawamura, Akito
AU - Nakamura, Hitoshi
AU - Yasumoto, Koji
AU - Tsuda, Masaki
AU - Okamoto, Naotaka
AU - Tanaka, Akihiro
AU - Matsunaga-Lee, Yasuharu
AU - Yano, Masamichi
AU - Egami, Yasuyuki
AU - Shutta, Ryu
AU - Tanouchi, Jun
AU - Yamada, Takahisa
AU - Yasumura, Yoshio
AU - Tamaki, Shunsuke
AU - Hayashi, Takaharu
AU - Nakagawa, Akito
AU - Nakagawa, Yusuke
AU - Sotomi, Yohei
AU - Nakatani, Daisaku
AU - Hikoso, Shungo
AU - Sakata, Yasushi
N1 - Publisher Copyright:
© 2021, International Heart Journal Association. All rights reserved.
PY - 2021
Y1 - 2021
N2 - Summary The obesity paradox states higher body mass index (BMI) is associated with better outcomes than normal weight in patients with heart failure with preserved ejection fraction (HFpEF). However, underweight was defined by BMI < 18.5 kg/m2, and results have been inconclusive, in part due to small number of participants. The number of underweight patients with HFpEF is higher in Asian than in Western countries. In this study, we aim to determine the prognostic impact of underweight in patients with HFpEF in Asian population. We enrolled 846 consecutive patients from the PURSUIT-HFpEF registry. We then divided them into three groups by BMI, namely, underweight (BMI < 18.5 kg/m2), normal weight (18.5 ≤BMI < 23), and overweight (23 ≤BMI). The underweight group consisted of 187 patients (22%). Over a mean follow-up of 407 days, 105 deaths were reported as all-cause mortality. On multivariable Cox analysis, the underweight group was determined to be significantly associated with higher risk of all-cause mortality than the normal and overweight groups (Hazard ratios [HR]: 2.33; 95% confidence intervals [CI]: 1.45-3.75, P < 0.001; HR: 3.54; 95% CI: 1.99-6.29, P < 0.001, respectively), after adjustment for age, sex, vital signs, and comorbidities. Underweight is a useful predictor of poor prognosis in patients with HFpEF in Asian population.
AB - Summary The obesity paradox states higher body mass index (BMI) is associated with better outcomes than normal weight in patients with heart failure with preserved ejection fraction (HFpEF). However, underweight was defined by BMI < 18.5 kg/m2, and results have been inconclusive, in part due to small number of participants. The number of underweight patients with HFpEF is higher in Asian than in Western countries. In this study, we aim to determine the prognostic impact of underweight in patients with HFpEF in Asian population. We enrolled 846 consecutive patients from the PURSUIT-HFpEF registry. We then divided them into three groups by BMI, namely, underweight (BMI < 18.5 kg/m2), normal weight (18.5 ≤BMI < 23), and overweight (23 ≤BMI). The underweight group consisted of 187 patients (22%). Over a mean follow-up of 407 days, 105 deaths were reported as all-cause mortality. On multivariable Cox analysis, the underweight group was determined to be significantly associated with higher risk of all-cause mortality than the normal and overweight groups (Hazard ratios [HR]: 2.33; 95% confidence intervals [CI]: 1.45-3.75, P < 0.001; HR: 3.54; 95% CI: 1.99-6.29, P < 0.001, respectively), after adjustment for age, sex, vital signs, and comorbidities. Underweight is a useful predictor of poor prognosis in patients with HFpEF in Asian population.
KW - Acute decompensated heart failure
KW - Body mass index
KW - Heart failure with preserved ejection fraction
KW - Obesity paradox
UR - http://www.scopus.com/inward/record.url?scp=85116458274&partnerID=8YFLogxK
U2 - 10.1536/ihj.21-195
DO - 10.1536/ihj.21-195
M3 - Article
C2 - 34544985
AN - SCOPUS:85116458274
SN - 1349-2365
VL - 62
SP - 1042
EP - 1051
JO - International Heart Journal
JF - International Heart Journal
IS - 5
ER -