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Body mass index in adults with congenital heart disease
Mahmoud Zaqout1,2, Kristof Vandekerckhove1, Nathalie Michels2
1Department of Pediatric Cardiology, Ghent University Hospital, Ghent, Belgium.
Insights
Adults with congenital heart disease (ACHD) tend to have lower body mass index (BMI) than the general population. Underweight is more common in severe ACHD cases, highlighting the need for monitoring BMI-related health issues.
Area of Science:
- Cardiology
- Public Health
- Human Physiology
Background:
- Congenital heart disease (CHD) significantly impacts adult health.
- Understanding body mass index (BMI) in adults with CHD (ACHD) is crucial for managing long-term health outcomes.
- Previous research has not fully elucidated BMI status across varying severities of ACHD.
Purpose of the Study:
- To investigate the prevalence and characteristics of body mass index (BMI) in a cohort of adults with congenital heart disease (ACHD).
- To compare BMI status in ACHD patients with a reference population.
- To explore associations between BMI, CHD severity, ventricular function, and exercise capacity.
Main Methods:
- A cohort of 539 adults with CHD (ACHD) was compared to a reference population (n=1737).
- CHD severity was categorized as mild, moderate, or severe.
- BMI was classified as underweight, normal, overweight, or obese. Ventricular function was assessed using echocardiography and MRI; exercise capacity was measured via cardiopulmonary exercise testing.
Main Results:
- ACHD patients exhibited slightly lower mean BMI compared to the reference group (24.1 vs 24.6).
- Men with mild and severe CHD, and women with severe CHD, showed significantly lower BMI than reference groups.
- Underweight (BMI <18.5) was notably more prevalent in women with severe CHD (22.2% vs 3.8%). BMI correlated with age and exercise capacity in mild/moderate CHD, and with ventricular function in women with Fontan circulation.
Conclusions:
- Underweight is a significant concern in adults with severe congenital heart disease (ACHD).
- Healthcare providers should monitor ACHD patients, particularly those with severe disease, for underweight and associated comorbidities.
- Further research into the clinical implications of altered BMI in ACHD is warranted.
Objective:
To investigate the status of body mass index (BMI) in adult people with congenital heart disease (ACHD).
Methods:
Five hundred thirty-nine adults with CHD (53.8% men) were seen in the outpatient clinic from 2013 to 2015 and compared to a reference population (n = 1737). The severity of CHD was categorized as mild, moderate, and severe according to standard guidelines. Patients were categorized based on BMI as underweight (<18.5), overweight (25-30), or obese (>30). Echocardiography and magnetic resonance imaging were used to measure ventricular function while exercise capacity was estimated via cardiopulmonary exercise test.
Results:
Adults with CHD had slightly lower BMI than the reference group (24.1 ± 4.3 vs 24.6 ± 4.3; P = .012). Men in the mild and severe group (23.9 ± 3.6; 23.3 ± 4.4 vs 25.1 ± 3.7; P = .007; P = .023) and women in the severe group (21.6 ± 3.3 vs 24.2 ± 4.7; P < .001) had lower BMI compared to the reference group. In the subgroups, men with ventricular septal defect, coarctation of aorta/ventricular septal defect and Fontan circulation and women with Fontan circulation had lower BMI than the reference group. Underweight was more prevalent in women with severe lesions compared to the reference group (22.2% vs 3.8%; P < .001). BMI was associated with age and exercise capacity in patients with mild and moderate lesions, while higher BMI was related to better ventricular function in women with Fontan circulation.
Conclusion:
Underweight was more prevalent in ACHD patients with severe lesions. Special attention should be paid to the possible existence of underweight-related comorbidities.
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