TY - JOUR
T1 - Impact of body mass index on diastolic function in patients with normal left ventricular ejection fraction
AU - Al Jaroudi, W.
AU - Halley, C.
AU - Houghtaling, P.
AU - Agarwal, S.
AU - Menon, V.
AU - Rodriguez, L.
AU - Grimm, R. A.
AU - Thomas, J. D.
AU - Jaber, W. A.
PY - 2012/8
Y1 - 2012/8
N2 - BACKGROUND: Obesity is a major public health epidemic and is associated with increased risk of heart failure and mortality. We evaluated the impact of body mass index (BMI) on the prevalence of diastolic dysfunction (DD). METHODS: We reviewed clinical records and echocardiogram of patients with baseline echocardiogram between 1996 and 2005 that showed normal left ventricular ejection fraction (LVEF). Diastolic function was labeled as normal, stage 1, stage 2 or stage 3/4 dysfunction. Patients were categorized as normal weight (BMI <25 kgm-2), overweight (25-29.9 kgm-2), obese (30-39.9 kgm-2) and morbidly obese (≥40 kgm-2). Multivariable ordinal and ordinary logistic regression were performed to identify factors associated with DD, and evaluate the independent relationship of BMI with DD. RESULTS: The cohort included 21 666 patients (mean (s.d.) age, 57.1 (15.1); 55.5% female). There were 7352 (33.9%) overweight, 5995 (27.6%) obese and 1616 (7.4%) morbidly obese patients. Abnormal diastolic function was present in 13 414 (61.9%) patients, with stage 1 being the most common. As BMI increased, the prevalence of normal diastolic function decreased (P<0.0001). Furthermore, there were 1733 patients with age <35 years; 460 (26.5%) and 407 (23.5%) were overweight and obese, respectively, and had higher prevalence of DD (P<0.001). Using multivariable logistic regression, BMI remained significant in both ordinal (all stages of diastolic function) and binary (normal versus abnormal). Also, obesity was associated with increased odds of DD in all patients and those aged <35 years. CONCLUSIONS: In patients with normal LVEF, higher BMI was independently associated with worsening DD.
AB - BACKGROUND: Obesity is a major public health epidemic and is associated with increased risk of heart failure and mortality. We evaluated the impact of body mass index (BMI) on the prevalence of diastolic dysfunction (DD). METHODS: We reviewed clinical records and echocardiogram of patients with baseline echocardiogram between 1996 and 2005 that showed normal left ventricular ejection fraction (LVEF). Diastolic function was labeled as normal, stage 1, stage 2 or stage 3/4 dysfunction. Patients were categorized as normal weight (BMI <25 kgm-2), overweight (25-29.9 kgm-2), obese (30-39.9 kgm-2) and morbidly obese (≥40 kgm-2). Multivariable ordinal and ordinary logistic regression were performed to identify factors associated with DD, and evaluate the independent relationship of BMI with DD. RESULTS: The cohort included 21 666 patients (mean (s.d.) age, 57.1 (15.1); 55.5% female). There were 7352 (33.9%) overweight, 5995 (27.6%) obese and 1616 (7.4%) morbidly obese patients. Abnormal diastolic function was present in 13 414 (61.9%) patients, with stage 1 being the most common. As BMI increased, the prevalence of normal diastolic function decreased (P<0.0001). Furthermore, there were 1733 patients with age <35 years; 460 (26.5%) and 407 (23.5%) were overweight and obese, respectively, and had higher prevalence of DD (P<0.001). Using multivariable logistic regression, BMI remained significant in both ordinal (all stages of diastolic function) and binary (normal versus abnormal). Also, obesity was associated with increased odds of DD in all patients and those aged <35 years. CONCLUSIONS: In patients with normal LVEF, higher BMI was independently associated with worsening DD.
KW - Body mass index
KW - Diastolic function
KW - Normal ejection function
KW - Outpatients
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U2 - 10.1038/nutd.2012.14
DO - 10.1038/nutd.2012.14
M3 - Article
C2 - 23448803
AN - SCOPUS:84880524195
SN - 2044-4052
VL - 2
JO - Nutrition and Diabetes
JF - Nutrition and Diabetes
IS - AUGUST
M1 - e39
ER -