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Influence of Body Mass Index on Recurrence of Ventricular Arrhythmia, Mortality in Defibrillator Recipients With

Rahul Samanta1, Arun Narayan2, Jim Pouliopoulos1

  • 1Department of Cardiology, Westmead Hospital, Sydney, NSW, Australia; The University of Sydney, Sydney, NSW, Australia.

Heart, Lung & Circulation
|March 30, 2019
PubMed

Insights

Normal body mass index (BMI) in patients with ischaemic heart disease and defibrillators is linked to worse outcomes for ventricular arrhythmias and mortality. Overweight and obese patients showed better survival rates, suggesting an obesity paradox.

Area of Science:

  • Cardiology
  • Clinical Medicine
  • Obesity Research

Background:

  • Obesity increases cardiovascular disease risk.
  • The impact of body mass index (BMI) on ventricular arrhythmias (VA) in ischaemic heart disease is not well understood.
  • This study investigates BMI's effect on VA recurrence and mortality in defibrillator recipients with ischaemic cardiomyopathy.

Purpose of the Study:

  • To examine the relationship between body mass index (BMI) and the recurrence of ventricular arrhythmias (VA) and mortality.
  • To assess the influence of BMI on outcomes in patients with ischaemic cardiomyopathy who received defibrillators.

Main Methods:

  • 123 patients with ischaemic cardiomyopathy (left ventricular ejection fraction ≤ 40%) and defibrillators were included.
  • Patients were categorized by BMI: normal (18.5-24.99), overweight (25-29.99), and obese (>30).

Main Results:

  • The combined endpoint of VA recurrence and mortality occurred in 36% of normal BMI, 5.4% of overweight, and 11.5% of obese patients (p=0.001).
  • Normal BMI was a significant predictor of worse outcomes (Hazard Ratio for Normal vs. Overweight = 7.1, p=0.002; Normal vs. Obese = 5.5, p=0.033) after adjusting for risk factors.
  • A trend towards reduced survival was observed in normal BMI patients compared to overweight and obese patients (p=0.08).

Conclusions:

  • Body mass index (BMI) significantly predicts ventricular arrhythmias (VA) and mortality in defibrillator recipients with ischaemic cardiomyopathy.
  • Normal BMI was associated with worse outcomes compared to overweight and obese patients.
  • These findings suggest an obesity paradox in ventricular arrhythmogenesis post-myocardial infarction.
Abstract

Keywords:
Ischaemic heart failureIschaemic ventricular arrhythmiasObesityVentricular tachycardia

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