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J Card Fail. 2003 Feb;9(1):29-35.

Body mass and survival in patients with chronic heart failure without cachexia: the importance of obesity.

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Department of Cardiac Medicine, National Heart & Lung Institute, London, United Kingdom.



Cachexia in chronic heart failure carries a poor prognosis, but little is known about the influence of body mass on the prognosis of noncachectic heart failure patients.


We studied 589 consecutive chronic heart failure patients followed for at least a year, in whom there were accurate baseline data for body mass.


Average age was 64.5 +/- 12.4 years, left ventricular ejection fraction (LVEF) 30.9 +/- 0.73%. Cachexia was present in 64. Noncachectic patients were divided into quintiles of body mass index (BMI), Q1 (BMI 22.2 +/- 1.5) to Q5 (BMI 34.1 +/- 2.8). There was no difference among the 5 groups in age, exercise capacity or LVEF. Survival was greatest in Q4 (1-year survival [95% confidence interval (CI)]) 0.91 (0.85-0.96) and 3-year survival 0.81 (0.73-0.89). Relative risks compared with Q4 were Q1: 2.3 (1.4-3.8); Q2: 1.7 (1.1-2.9); Q3: 1.8 (1.1-3.0); and Q5: 1.5 (0.9-2.5). In multivariate analysis of 1 year follow-up, peak oxygen consumption (hazard ratio with 95% CI) (0.89 [0.82-0.97]; P =.006), LVEF (0.94 [0.91-0.97]; P =.0002) and BMI (0.90 [0.82-0.98]; P =.02) independently predicted 1-year survival with a combined Chi;(2) value of 42.4. Age (1.01 [0.98-1.05] and diagnosis (1.56 [0.78-3.11]) was not a predictor of survival.


In patients with chronic heart failure, increasing BMI is not an adverse prognostic feature. Thinner patients appear to have a poorer prognosis.

[Indexed for MEDLINE]

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