title: Right ventricular function measured by TAPSE in obese subjects at the time of acute myocardial infarction and 2year outcomes.
abstract: BACKGROUND
  Obesity is associated with significantly better outcome after acute myocardial infarction (AMI), a phenomenon known as 'obesity paradox'. Tricuspid annular plane systolic excursion (TAPSE) is an echocardiographic measurement of right ventricular (RV) function and has prognostic implications at the time of AMI.
  
  
  METHODS
  We examined the difference in RV function among patients admitted with AMI according to obesity status. In a single center cohort analysis of 105 patients admitted between 2010 and 2011 with the diagnosis of AMI. Demographic, anthropometric data and cardiovascular risk factors were prospectively collected. All subjects had echocardiogram within 48h of AMI diagnosis for TAPSE calculations. Subjects were divided into two groups based on their obesity status.
  
  
  RESULTS
  Obese subjects had better RV function compared to non-obese, TAPSE: 19±6.6 vs. 16±4.9mm; p 0.02 at the time of AMI. There was no significant difference in TAPSE between OSA and non-OSA subjects, 19±6.3 vs. 17±6.2mm; p 0.21. After 2years of follow up, patients with obesity and better RV function were less likely to develop new onset heart failure (HF) with OR 0.30 (95% CI 0.09-0.93; p 0.03) and OR 0.31 (95% CI 0.11-0.76; p 0.007) respectively.
  
  
  CONCLUSIONS
  Obese patients had better RV function measured by TAPSE at the time AMI when compared non-obese patients. Patients with better RV function at the time of AMI were less likely to develop new-onset HF and there was a trend in the obese group to less likely develop new-onset HF after 2year follow up.
authors.affiliation: Department of Internal Medicine, Einstein Healthcare Network, Philadelphia, PA 19141, United States.
authors.forename: Yaser S
authors.initials: YS
authors.lastname: Alhamshari
authors.affiliation: Department of Internal Medicine, Einstein Healthcare Network, Philadelphia, PA 19141, United States.
authors.forename: Talal
authors.initials: T
authors.lastname: Alnabelsi
authors.affiliation: Department of Internal Medicine, Einstein Healthcare Network, Philadelphia, PA 19141, United States.
authors.forename: Ramzi
authors.initials: R
authors.lastname: Mulki
authors.affiliation: The Institute for Heart and Vascular Health and Cardiovascular Diseases, Einstein Healthcare Network, Philadelphia, PA 19141, United States.
authors.forename: Beatriz
authors.initials: B
authors.lastname: Cepeda-Valery
authors.affiliation: The Institute for Heart and Vascular Health and Cardiovascular Diseases, Einstein Healthcare Network, Philadelphia, PA 19141, United States.
authors.forename: Vincent M
authors.initials: VM
authors.lastname: Figueredo
authors.affiliation: The Institute for Heart and Vascular Health and Cardiovascular Diseases, Einstein Healthcare Network, Philadelphia, PA 19141, United States. Electronic address: romeroab@einstein.edu.
authors.forename: Abel
authors.initials: A
authors.lastname: Romero-Corral
mesh_terms: D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D009765:Obesity / Q000150:complications* / Q000453:epidemiology; D010414:Pennsylvania / Q000453:epidemiology; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D013599:Systole; D013997:Time Factors; D014261:Tricuspid Valve / Q000000981:diagnostic imaging* / Q000503:physiopathology; D016278:Ventricular Function, Right / Q000502:physiology*
keywords: Obesity paradox; RV function; TAPSE