Nav: Home

Acute heart failure patients with 'metabolically healthy obesity' have better survival

December 06, 2018

Milan, Italy - 6 December 2018: Acute heart failure patients with 'metabolically healthy obesity' have better survival than those with 'metabolically unhealthy obesity' or with normal weight regardless of metabolic status, according to a study presented today at EuroEcho-Imaging 2018.1 Obese patients had less deterioration in heart structure and function.

Obesity is an independent risk factor for developing heart failure. However, once heart failure is diagnosed, obesity is associated with lower mortality - the so-called obesity paradox.2

This study explored whether this paradox might be explained by metabolic health and by heart structure and function. The term 'metabolically healthy obesity' refers to people who are obese but do not have metabolic risk factors such as high blood pressure, high cholesterol, and glucose intolerance.3

This retrospective cohort study enrolled 3,564 patients admitted to hospital with acute heart failure between 2009 and 2016. Of those, 2,021 were overweight-to-obese (BMI 23 kg/m2 or above) and 1,543 were a normal weight (BMI less than 23 kg/m2). Data on blood pressure, cholesterol and glucose were collected. Echocardiography was used to assess left ventricular (LV) ejection fraction, global longitudinal strain (GLS), and geometry.

Patients were followed-up for a median of 33.7 months. The primary outcome was all-cause mortality. Metabolically healthy obese patients had a significantly better survival rate (79.4%) than metabolically unhealthy obese patients (66.5%). Their survival was also significantly better than normal weight patients with good (63.9%) and poor (55.5%) metabolic health.

Compared to normal weight patients, overweight-to-obese patients had a significantly lower rate of eccentric LV hypertrophy (62.4% versus 49.1%) and higher LV GLS (10.5% versus 11.0%) and LV ejection fraction (38.9% versus 41.6%).Higher BMIs were associated with lower mortality risks overall and in all subgroups of LV GLS or LV geometry.

Lead author Dr Chan Soon Park, cardiologist, Seoul National University Hospital, Seoul, Korea, said: "Our findings provide insights into why obesity is protective in patients with heart failure. Based on our study, obese patients have less eccentric hypertrophy and greater LV GLS and LV ejection fraction, meaning there is less deterioration in the structure and function of the heart. In addition, we found that metabolic health, such as blood pressure, blood cholesterol, and glucose tolerance, plays a role, with metabolically healthy obese patients having the best chance of survival.

Regarding the implications of the results, Dr Park said: "Assessing heart structure and function, and metabolic health status, in patients with heart failure may be a promising way to identify those at greater risk of premature death. Further studies are needed to see if preventing and treating metabolic abnormalities - for example with statins and blood pressure lowering medications - can improve the prognosis of overweight and obese patients with heart failure."
-end-
Authors: ESC Press Office
Tel: +33 (0)4 8987 2499
Email: press@escardio.org
Follow ESC latest news on Twitter @ESCardioNews

Notes to editor

SOURCES OF FUNDING: None.

DISCLOSURES: None.

References and notes

1The abstract 'Obesity, myocardial function, geometry, and prognosis in acute heart failure' will be presented during the session New insight in the evaluation of myocardial systolic and diastolic function on 6 December, 15:30 to 16:30 CET, in the Moderated ePosters 1 area. 2Ponikowski P, Voors AA, Anker SD, et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J. 2016;37:2129-2200. 3Piepoli MF, Hoes AW, Agewall S, et al. 2016 European Guidelines on cardiovascular disease prevention in clinical practice. Eur Heart J. 2016;37:2315-2381.

About the European Association of Cardiovascular Imaging (EACVI)

The European Association of Cardiovascular Imaging (EACVI) - a branch of the ESC - is the world leading network of Cardiovascular Imaging (CVI) experts, gathering four imaging modalities under one entity (Echocardiography, Cardiovascular Magnetic Resonance, Nuclear Cardiology and Cardiac Computed Tomography). Its aim is to promote excellence in clinical diagnosis, research, technical development, and education in cardiovascular imaging. The EACVI welcomes over 11,000 professionals including cardiologists, sonographers, nurses, basic scientists and allied professionals.

About the European Society of Cardiology

The European Society of Cardiology brings together health care professionals from more than 150 countries, working to advance cardiovascular medicine and help people lead longer, healthier lives.

Information for journalists attending EuroEcho-Imaging 2018

EuroEcho-Imaging 2018 takes place 5 to 8 December at the MiCo Milano Congressi in Milan, Italy. Explore the scientific programme.
  • To register on-site please bring a valid press card or appropriate letter of assignment with proof of three recent published articles (cardiology or health-related, or referring to a previous ESC Event).


European Society of Cardiology

Related Heart Failure Articles:

New hope for treating heart failure
Heart failure patients who are getting by on existing drug therapies can look forward to a far more effective medicine in the next five years or so, thanks to University of Alberta researchers.
Activated T-cells drive post-heart attack heart failure
Chronic inflammation after a heart attack can promote heart failure and death.
ICU care for COPD, heart failure and heart attack may not be better
Does a stay in the intensive care unit give patients a better chance of surviving a chronic obstructive pulmonary disease (COPD) or heart failure flare-up or even a heart attack, compared with care in another type of hospital unit?
Tissue engineering advance reduces heart failure in model of heart attack
Researchers have grown heart tissue by seeding a mix of human cells onto a 1-micron-resolution scaffold made with a 3-D printer.
Smoking may lead to heart failure by thickening the heart wall
Smokers without obvious signs of heart disease were more likely than nonsmokers and former smokers to have thickened heart walls and reduced heart pumping ability.
After the heart attack: Injectable gels could prevent future heart failure (video)
During a heart attack, clots or narrowed arteries block blood flow, harming or killing cells in the heart.
Heart failure after first heart attack may increase cancer risk
People who develop heart failure after their first heart attack have a greater risk of developing cancer when compared to first-time heart attack survivors without heart failure, according to a study today in the Journal of the American College of Cardiology.
Scientists use 'virtual heart' to model heart failure
A team of researchers have created a detailed computational model of the electrophysiology of congestive heart failure, a leading cause of death.
Increase in biomarker linked with increased risk of heart disease, heart failure, death
In a study published online by JAMA Cardiology, Elizabeth Selvin, Ph.D., M.P.H., of the Johns Hopkins Bloomberg School of Public Health, Baltimore, and colleagues examined the association of six-year change in high-sensitivity cardiac troponin T with incident coronary heart disease, heart failure and all-cause mortality.
1 in 4 patients develop heart failure within 4 years of first heart attack
One in four patients develop heart failure within four years of a first heart attack, according to a study in nearly 25,000 patients presented today at Heart Failure 2016 and the 3rd World Congress on Acute Heart Failure by Dr.

Related Heart Failure Reading:

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Climate Crisis
There's no greater threat to humanity than climate change. What can we do to stop the worst consequences? This hour, TED speakers explore how we can save our planet and whether we can do it in time. Guests include climate activist Greta Thunberg, chemical engineer Jennifer Wilcox, research scientist Sean Davis, food innovator Bruce Friedrich, and psychologist Per Espen Stoknes.
Now Playing: Science for the People

#527 Honey I CRISPR'd the Kids
This week we're coming to you from Awesome Con in Washington, D.C. There, host Bethany Brookshire led a panel of three amazing guests to talk about the promise and perils of CRISPR, and what happens now that CRISPR babies have (maybe?) been born. Featuring science writer Tina Saey, molecular biologist Anne Simon, and bioethicist Alan Regenberg. A Nobel Prize winner argues banning CRISPR babies won’t work Geneticists push for a 5-year global ban on gene-edited babies A CRISPR spin-off causes unintended typos in DNA News of the first gene-edited babies ignited a firestorm The researcher who created CRISPR twins defends...