title: Waist circumference, but not body mass index, is a predictor of ventricular remodeling after anterior myocardial infarction.
abstract: OBJECTIVE
  The impact of obesity on ventricular remodeling after myocardial infarction (MI) is still poorly understood. Therefore, the aim of this study was to evaluate the role of waist circumference (WC) and body mass index as predictors of cardiac remodeling in patients after an anterior MI.
  
  
  METHODS
  Eighty-three consecutive patients with anterior MI were prospectively evaluated. Clinical characteristics and echocardiographic data were analyzed at admission and at a 6-mo follow-up. Ventricular remodeling was defined as a 10% increase in left ventricular end-systolic or end-diastolic diameter at the 6-mo follow-up.
  
  
  RESULTS
  In our study, 83 consecutive patients were evaluated (72% men). Ventricular remodeling was present in 31% of the patients (77% men). Patients with remodeling had higher creatine phosphokinase and creatine phosphokinase-MB peak values, a higher resting heart rate, a larger left atrial diameter, and a larger interventricular septum diastolic thickness. In addition, patients with remodeling had lower peak velocity of early ventricular filling deceleration time and ejection fraction. Patients with remodeling presented higher WC values (with remodeling, 99.2 ± 10.4 cm; without remodeling, 93.9 ± 10.8 cm, P = 0.04), but there were no differences in the body mass index values. In the logistic regression analysis, WC, adjusted by age, gender, ejection fraction, and creatine phosphokinase levels, was an independent predictor of left ventricular remodeling (odds ratio 1.067, 95% confidence interval 1.001-1.129, P = 0.02).
  
  
  CONCLUSIONS
  Waist circumference, but not body mass index, is a predictor of ventricular remodeling after an anterior MI. Therefore, the WC of these patients should be measured in clinical practice.
authors.affiliation: Internal Medicine Department, Botucatu Medical School, São Paulo State University, Botucatu, São Paulo, Brazil.
authors.forename: Ana Lucia
authors.initials: AL
authors.lastname: Cogni
authors.forename: Elaine
authors.initials: E
authors.lastname: Farah
authors.forename: Marcos F
authors.initials: MF
authors.lastname: Minicucci
authors.forename: Paula S
authors.initials: PS
authors.lastname: Azevedo
authors.forename: Katashi
authors.initials: K
authors.lastname: Okoshi
authors.forename: Beatriz B
authors.initials: BB
authors.lastname: Matsubara
authors.forename: Silméia G
authors.initials: SG
authors.lastname: Zanati
authors.forename: Sergio A R
authors.initials: SA
authors.lastname: Paiva
authors.forename: Leonardo A M
authors.initials: LA
authors.lastname: Zornoff
mesh_terms: D000368:Aged; D015992:Body Mass Index; D018618:Echocardiography, Doppler, Color; D018619:Echocardiography, Doppler, Pulsed; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000473:pathology*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D020257:Ventricular Remodeling; D055105:Waist Circumference