Obesity paradox in chronic heart failure with moderately reduced or preserved left ventricular ejection fraction: impact on a prognosis for patients according to a five-year follow-up
Aim. To investigate the obesity paradox by studying the impact of overweight and abdominal obesity on the prognosis in chronic heart failure (CHF) patients with moderately reduced or preserved left ventricular ejection fraction (LVEF) by five-year follow-up results. Materials and methods. A prosp...
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Zaporizhzhia State Medical and Pharmaceutical University
2023-07-01
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| Series: | Zaporožskij Medicinskij Žurnal |
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| Online Access: | http://zmj.zsmu.edu.ua/article/view/280957/279335 |
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| author | P. P. Bidzilya V. H. Kadzharian M. V. Bychko |
| author_facet | P. P. Bidzilya V. H. Kadzharian M. V. Bychko |
| author_sort | P. P. Bidzilya |
| collection | DOAJ |
| description | Aim. To investigate the obesity paradox by studying the impact of overweight and abdominal obesity on the prognosis in chronic heart failure (CHF) patients with moderately reduced or preserved left ventricular ejection fraction (LVEF) by five-year follow-up results.
Materials and methods. A prospective, open, parallel-group study included 314 CHF patients with moderately reduced or preserved LVEF, average age was 65.3 ± 11.2 years. Group 1 – 66 patients with normal weight; Group 2 – 67 overweight patients; Group 3 – 90 patients with I degree abdominal obesity; Group 4 – 91 subjects with II–III degrees of obesity.
Adverse cardiovascular events (CVEs) were studied as a cumulative endpoint, cardiovascular death, and rehospitalization due to decompensated CHF.
Results. It has been found that excess body weight (overweight and I–III degrees of abdominal obesity) did not affect the prevalence and spectrum of adverse CVEs in CHF patients with moderately reduced and preserved LVEF. In overweight patients, compared to I degree obesity group, the incidence of cumulative end point (by 15.4 %; χ2 = 3.95, p < 0.05) and cases of re-hospitalization (by 19.0 %; χ2 = 5.6, p < 0.05) were more often observed.
Concomitant overweight was associated with an increased risk for faster onset of the cumulative end point (HR 1.46, 95 % CI 1.1–2.2, p < 0.05) and re-hospitalization (HR 1.53, 95 % CI 1.1–2.4, p < 0.05).
Conclusions. The presence of excess body weight (overweight and I–III degrees of abdominal obesity) did not affect the prevalence and spectrum of adverse CVEs in CHF patients with moderately reduced and preserved LVEF during the five-year follow-up. In the presence of overweight, in comparison with I degree abdominal obesity, the incidence of cumulative end point and re-hospitalization due to the disease decompensation were more often observed, which could be evidence for the existence of the obesity paradox.
The most adverse effect on the prognosis in CHF patients with moderately reduced and preserved LVEF caused by concomitant overweight, in the presence of which, there was a significant increase in the risk for more faster onset of cumulative end point and re-hospitalization due to decompensation of the disease. |
| format | Article |
| id | doaj-art-b05f334a0dfe4e4096d7c2b9b5c477ba |
| institution | OA Journals |
| issn | 2306-4145 2310-1210 |
| language | English |
| publishDate | 2023-07-01 |
| publisher | Zaporizhzhia State Medical and Pharmaceutical University |
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| series | Zaporožskij Medicinskij Žurnal |
| spelling | doaj-art-b05f334a0dfe4e4096d7c2b9b5c477ba2025-08-20T01:59:56ZengZaporizhzhia State Medical and Pharmaceutical UniversityZaporožskij Medicinskij Žurnal2306-41452310-12102023-07-0125430330810.14739/2310-1210.2023.4.280957Obesity paradox in chronic heart failure with moderately reduced or preserved left ventricular ejection fraction: impact on a prognosis for patients according to a five-year follow-upP. P. Bidzilya0https://orcid.org/0000-0003-2451-317XV. H. Kadzharian1https://orcid.org/0000-0003-2542-7142M. V. Bychko2https://orcid.org/0009-0003-7880-6581Zaporizhzhia State Medical and Pharmaceutical University, UkraineZaporizhzhia State Medical and Pharmaceutical University, UkraineUzhhorod National University, UkraineAim. To investigate the obesity paradox by studying the impact of overweight and abdominal obesity on the prognosis in chronic heart failure (CHF) patients with moderately reduced or preserved left ventricular ejection fraction (LVEF) by five-year follow-up results. Materials and methods. A prospective, open, parallel-group study included 314 CHF patients with moderately reduced or preserved LVEF, average age was 65.3 ± 11.2 years. Group 1 – 66 patients with normal weight; Group 2 – 67 overweight patients; Group 3 – 90 patients with I degree abdominal obesity; Group 4 – 91 subjects with II–III degrees of obesity. Adverse cardiovascular events (CVEs) were studied as a cumulative endpoint, cardiovascular death, and rehospitalization due to decompensated CHF. Results. It has been found that excess body weight (overweight and I–III degrees of abdominal obesity) did not affect the prevalence and spectrum of adverse CVEs in CHF patients with moderately reduced and preserved LVEF. In overweight patients, compared to I degree obesity group, the incidence of cumulative end point (by 15.4 %; χ2 = 3.95, p < 0.05) and cases of re-hospitalization (by 19.0 %; χ2 = 5.6, p < 0.05) were more often observed. Concomitant overweight was associated with an increased risk for faster onset of the cumulative end point (HR 1.46, 95 % CI 1.1–2.2, p < 0.05) and re-hospitalization (HR 1.53, 95 % CI 1.1–2.4, p < 0.05). Conclusions. The presence of excess body weight (overweight and I–III degrees of abdominal obesity) did not affect the prevalence and spectrum of adverse CVEs in CHF patients with moderately reduced and preserved LVEF during the five-year follow-up. In the presence of overweight, in comparison with I degree abdominal obesity, the incidence of cumulative end point and re-hospitalization due to the disease decompensation were more often observed, which could be evidence for the existence of the obesity paradox. The most adverse effect on the prognosis in CHF patients with moderately reduced and preserved LVEF caused by concomitant overweight, in the presence of which, there was a significant increase in the risk for more faster onset of cumulative end point and re-hospitalization due to decompensation of the disease.http://zmj.zsmu.edu.ua/article/view/280957/279335chronic heart failuremoderately reduced ejection fractionpreserved ejection fractionoverweightobesityprognosis |
| spellingShingle | P. P. Bidzilya V. H. Kadzharian M. V. Bychko Obesity paradox in chronic heart failure with moderately reduced or preserved left ventricular ejection fraction: impact on a prognosis for patients according to a five-year follow-up Zaporožskij Medicinskij Žurnal chronic heart failure moderately reduced ejection fraction preserved ejection fraction overweight obesity prognosis |
| title | Obesity paradox in chronic heart failure with moderately reduced or preserved left ventricular ejection fraction: impact on a prognosis for patients according to a five-year follow-up |
| title_full | Obesity paradox in chronic heart failure with moderately reduced or preserved left ventricular ejection fraction: impact on a prognosis for patients according to a five-year follow-up |
| title_fullStr | Obesity paradox in chronic heart failure with moderately reduced or preserved left ventricular ejection fraction: impact on a prognosis for patients according to a five-year follow-up |
| title_full_unstemmed | Obesity paradox in chronic heart failure with moderately reduced or preserved left ventricular ejection fraction: impact on a prognosis for patients according to a five-year follow-up |
| title_short | Obesity paradox in chronic heart failure with moderately reduced or preserved left ventricular ejection fraction: impact on a prognosis for patients according to a five-year follow-up |
| title_sort | obesity paradox in chronic heart failure with moderately reduced or preserved left ventricular ejection fraction impact on a prognosis for patients according to a five year follow up |
| topic | chronic heart failure moderately reduced ejection fraction preserved ejection fraction overweight obesity prognosis |
| url | http://zmj.zsmu.edu.ua/article/view/280957/279335 |
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