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Obesity and its association to phenotype and clinical course in hypertrophic cardiomyopathy

Iacopo Olivotto1, Barry J Maron, Benedetta Tomberli

  • 1Referral Center for Myocardial Diseases, Azienda Ospedaliera Universitaria Careggi, Florence, Italy. olivottoi@aou-careggi.toscana.it

Journal of the American College of Cardiology
|May 7, 2013
PubMed

Insights

Obesity significantly increases left ventricular mass and heart failure progression in hypertrophic cardiomyopathy (HCM) patients. Managing body mass index (BMI) is crucial for improving clinical outcomes in this population.

Area of Science:

  • Cardiology
  • Genetics
  • Internal Medicine

Background:

  • The influence of obesity on cardiac phenotype and clinical course in hypertrophic cardiomyopathy (HCM) remains unclear.
  • Obesity is a common condition that promotes left ventricular (LV) hypertrophy in the general population.

Purpose of the Study:

  • To investigate the impact of body mass index (BMI) on cardiac phenotype and clinical course in a multicenter HCM cohort.
  • To determine if obesity is associated with increased LV mass and heart failure progression in HCM patients.

Main Methods:

  • A multicenter cohort of 275 adult HCM patients was analyzed.
  • Cardiovascular magnetic resonance (CMR) was used to assess LV mass.
  • The relationship between BMI and heart failure progression was evaluated over a median follow-up of 3.7 years.

Main Results:

  • Higher BMI (pre-obese and obese) was independently associated with significantly increased LV mass.
  • Obese HCM patients had a 3.6-fold increased risk of developing NYHA functional class III-IV symptoms.
  • The proportion of obese patients in NYHA functional class III at follow-up was double that of normal-weight patients.

Conclusions:

  • Obesity is an independent predictor of increased LV mass in HCM patients.
  • Extrinsic factors like obesity can influence the progression of heart failure symptoms in HCM.
  • Managing BMI may be a key therapeutic strategy to improve outcomes in HCM.
Abstract

Keywords:
BMICMRHCMHRLGELVLVHNYHANew York Heart Associationbody mass indexcardiac magnetic resonancecardiovascular magnetic resonancehazard ratiohypertrophic cardiomyopathyhypertrophylate gadolinium enhancementleft ventricularleft ventricular hypertrophyobesityoutcome

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