title: Obesity, brain natriuretic peptide levels and mortality in patients hospitalized with heart failure and preserved left ventricular systolic function.
abstract: BACKGROUND
  An inverse relationship between brain natriuretic peptide (BNP) levels and body mass index (BMI) has been described for patients with left ventricular (LV) systolic dysfunction. In this study, the association of BMI, BNP levels and mortality in patients hospitalized for heart failure with preserved LV systolic function (HFpLVF) was investigated.
  
  
  METHODS
  One hundred fifty consecutive patients (98% men) who were hospitalized with HFpLVF and had BNP levels measured on admission were analyzed. Patients were divided into categories of BMI: normal (BMI < 25 kg/m), overweight (BMI 25-29.9 kg/m) and obese (BMI ≥ 30 kg/m). Relevant clinical and echocardiographic characteristics and all-cause mortality were obtained through chart review.
  
  
  RESULTS
  BNP levels were significantly lower in obese (median = 227 pg/mL) and overweight (median = 396 pg/mL) patients compared with those with normal BMI (median = 608 pg/mL, P = 0.003). Higher BMI predicted BNP levels of <100 pg/mL. Compared with patients with normal BMI, overweight and obese patients had a significantly lower risk of total mortality, even after adjusting for other clinical characteristics, including log-transformed BNP levels, atrial fibrillation, the use of beta-blockers at discharge, age, hemoglobin levels and the presence of pulmonary congestion on admission. Higher BNP levels also independently predicted mortality.
  
  
  CONCLUSIONS
  An inverse relationship between BMI and BNP levels exists in patients hospitalized with HFpLVF. Higher BMI is associated with lower mortality, whereas higher BNP levels predict higher mortality in male patients with HFpLVF. These findings should be confirmed in a larger multicenter setting.
authors: Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, OK, USA. stavros-stavrakis@ouhsc.edu
authors: Stavros
authors: S
authors: Stavrakis
authors: Aneesh
authors: A
authors: Pakala
authors: Jimmy
authors: J
authors: Thomas
authors: Muhammad A
authors: MA
authors: Chaudhry
authors: Udho
authors: U
authors: Thadani
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000097:blood / Q000150:complications / Q000188:drug therapy / Q000401:mortality / Q000503:physiopathology; D015992:Body Mass Index; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000150:complications / Q000188:drug therapy / Q000401:mortality / Q000503:physiopathology; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D009765:Obesity / Q000097:blood / Q000150:complications / Q000188:drug therapy / Q000401:mortality / Q000503:physiopathology; D012189:Retrospective Studies; D016277:Ventricular Function, Left
chemical_list: D000319:Adrenergic beta-Antagonists; D020097:Natriuretic Peptide, Brain