The role of body composition in left ventricular remodeling, reverse remodeling, and clinical outcomes for heart failure with mildly reduced ejection fraction: more knowledge to the “obesity paradox”
Authors' conclusion
Body composition played an important role in the LVRR and clinical outcomes for HFmrEF. For HFmrEF patients, BMI and fat mass was positively associated with the cumulative incidence of LVRR, while higher fat mass and PBF predicted lower risk of adverse clinical events but not LMI.
Study context
- Population
- Consecutive patients with heart failure (HF) with mildly reduced ejection fraction (left ventricular ejection fraction (LVEF) 40–49%), January 2016 to December 2021
- Participants
- 240 patients
- Exposure
- HF with mildly reduced ejection fraction (HFmrEF) patients with vs without LV reverse remodeling (LVRR); body composition parameters as exposures
- LVRRn = 113
- Outcome
- LVRR: reduction >10% in LVEDDI or LVEDDI <33 mm/m²; absolute LVEF increase >10 points vs baseline or follow-up LVEF ≥50%
- Follow-up
- 1-year follow-up
Methodological detailssingle-centre, echocardiography-based
- Single-centre
- Echocardiography-based
Main finding
As reported in the abstract
LVRR · 1 year
Hazard ratio (95% CI)P value
Higher BMI
1.042(1.002–1.083)
P = 0.037Higher fat mass
1.019(1.002–1.036)
P = 0.026- Patients who developed LVRR
- 113 (47.1%)
Observational data: associations, not effects.
Secondary outcomes
Fat mass
P = 0.034
PBF
P = 0.047
Composite of re-hospitalization for HF or cardiovascular death
| aHR (95% CI) | P value | ||
|---|---|---|---|
| Higher fat mass | 0.957 (0.917–0.999) | P = 0.049 | |
| Higher PBF | 0.963 (0.924–0.976) | P = 0.043 | |
| 0.512Adjusted hazard ratio (log scale) |
Anthropometric parameters vs baseline LV end-diastolic diameter index (LVEDDI)
- Significant negative correlation between anthropometric parameters and baseline LVEDDI
- all P < 0.05
- Higher body mass index (BMI), fat mass, percent body fat (PBF), CUN-BAE index and lean mass index (LMI): more pronounced and persistent LVEF increase and left ventricular (LV) mass index decline
Original publication
The role of body composition in left ventricular remodeling, reverse remodeling, and clinical outcomes for heart failure with mildly reduced ejection fraction: more knowledge to the “obesity paradox”. Cardiovasc Diabetol. Published 11 September 2024. doi:10.
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