title: Association of body mass index with cardiac reverse remodeling and long-term outcome in advanced heart failure patients with cardiac resynchronization therapy.
abstract: BACKGROUND
  The effect of adiposity on response to cardiac resynchronization therapy (CRT) and long-term outcome in patients undergoing CRT has not been previously reported. This study assessed the impact of baseline body mass index (BMI) on cardiac reverse remodeling and prognosis following CRT. METHODS AND RESULTS: A total of 247 CRT patients were included and divided into 4 groups according to baseline BMI. During 6-month follow-up, overweight and obese patients (BMI, 24-28 kg/m(2), ≥28 kg/m(2), respectively) were inclined to have better clinical and echocardiographic improvements (P<0.05) as well as higher response rate (P<0.001) than underweight and normal weight patients (BMI, <18.5 kg/m(2), 18.5-24 kg/m(2), respectively). During long-term follow-up, overweight and obese patients had lower all-cause mortality (P=0.015) and combined endpoint of death or HF hospitalizations (P=0.001) than underweight and normal weight patients. Compared with normal weight patients, underweight patients had a 2.29-fold increase in risk of combined endpoint events whereas overweight and obese patients had a reduction in the risk of death (66% and 58%, respectively) and combined endpoint events (52% and 38%, respectively).
  
  
  CONCLUSIONS
  Patients with obesity and overweight derived more benefit from CRT. Higher BMI was independently associated with better clinical outcome in CRT patients.
authors.affiliation: The Cardiac Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College.
authors.forename: Chi
authors.initials: C
authors.lastname: Cai
authors.forename: Wei
authors.initials: W
authors.lastname: Hua
authors.forename: Li-Gang
authors.initials: LG
authors.lastname: Ding
authors.forename: Jing
authors.initials: J
authors.lastname: Wang
authors.forename: Ke-Ping
authors.initials: KP
authors.lastname: Chen
authors.forename: Xin-Wei
authors.initials: XW
authors.lastname: Yang
authors.forename: Zhi-Min
authors.initials: ZM
authors.lastname: Liu
authors.forename: Shu
authors.initials: S
authors.lastname: Zhang
mesh_terms: D050154:Adiposity; D000368:Aged; D015415:Biomarkers; D015992:Body Mass Index; D058406:Cardiac Resynchronization Therapy; D002423:Cause of Death; D015897:Comorbidity; D018618:Echocardiography, Doppler, Color; D004554:Electric Countershock; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000401:mortality* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology / Q000503:physiopathology; D050177:Overweight / Q000453:epidemiology* / Q000503:physiopathology; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D013318:Stroke Volume; D020257:Ventricular Remodeling
chemical_list: D015415:Biomarkers