Effects of left ventricular geometry and obesity on mortality in women with normal ejection fraction
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Output type: Journal article
Author list: Patel D., Lavie C., Artham S., Milani R., Cardenas G., Ventura H.
Publisher: Elsevier
Publication year: 2014
Journal: American Journal of Cardiology (0002-9149)
Volume number: 113
Issue number: 5
Start page: 877
End page: 880
Number of pages: 4
ISSN: 0002-9149
URL: http://api.elsevier.com/content/abstract/scopus_id:84893912945
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Open access status: closed
Abstract
Left ventricular (LV) geometry is an independent predictor of cardiovascular morbidity and mortality. Although obesity is a known risk factor for cardiovascular diseases, studies have suggested a paradoxical relation between obesity and prognosis. We retrospectively assessed 26,126 female patients with normal LV ejection fraction to determine the impact of LV geometry, including normal structure, concentric remodeling, and eccentric or concentric LV hypertrophy, and obesity on mortality during an average follow-up of 1.7 years. Abnormal LV geometry occurred more commonly in obese (body mass index ≥30 kg/m, n = 10,465) compared with nonobese (body mass index <30 kg/m, n = 15,661) patients (56% vs 47%, respectively, p <0.0001). Overall mortality, however, was considerably less in obese compared with nonobese patients (5.6% vs 8.7%, respectively, p <0.0001). In both groups, progressive increases in mortality were observed from normal structure to concentric remodeling and then to eccentric and concentric LV hypertrophy (obese patients 2.9%, 6.5%, 6.7%, and 11.1%, respectively, and nonobese patients 5.3%, 10.6%, 11.4%, and 16.8%, respectively, p <0.0001 for trend). In conclusion, although an obesity paradox exists, in that obesity in women is associated with abnormal LV geometry but less mortality, our data demonstrate that abnormal LV geometric patterns are highly prevalent in both obese and nonobese female patients with normal ejection fraction and are associated with greater mortality. © 2014 Elsevier Inc. All rights reserved.
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