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Impact of body mass index on left atrial dimension in HOCM patients
Yue Zhou1,2, Miao Yu1,2, Jingang Cui1
1Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Xicheng District, Beijing 100037, China.
Insights
Body mass index (BMI) is linked to left atrial (LA) size in hypertrophic obstructive cardiomyopathy (HOCM). While obesity is associated with LA enlargement, it does not independently predict atrial fibrillation (AF) in HOCM patients.
Area of Science:
- Cardiology
- Obesity Research
- Cardiovascular Disease
Background:
- Left atrial (LA) enlargement predicts atrial fibrillation (AF).
- Obesity is a modifiable cardiovascular disease risk factor.
- The relationship between body mass index (BMI) and LA dimension in hypertrophic obstructive cardiomyopathy (HOCM) is not well understood.
Purpose of the Study:
- To investigate the association between BMI and LA dimension in HOCM patients.
- To determine if BMI independently predicts AF in HOCM.
Main Methods:
- 423 HOCM patients were stratified by BMI into normal weight, overweight, and obesity groups.
- Statistical analyses included multiple linear regression and multivariable binary logistic regression.
- LA diameter and AF prevalence were assessed in relation to BMI and other clinical factors.
Main Results:
- Obesity was associated with lower prevalence of syncope, moderate/severe mitral regurgitation, and lower NT-proBNP levels.
- BMI, log NT-proBNP, AF presence, and left ventricular diastolic diameter index were independently related to LA diameter.
- BMI was not an independent predictor of AF prevalence in HOCM patients.
Conclusions:
- BMI is independently associated with LA diameter in HOCM.
- BMI does not independently predict AF prevalence in HOCM.
- Findings suggest BMI may influence AF incidence via LA enlargement in HOCM.
Background:
Substantial studies have demonstrated that left atrial (LA) enlargement was a robust predictor of atrial fibrillation (AF) and obesity was a modifiable risk factor for cardiovascular diseases. However, the role of body mass index (BMI) on LA dimension in hypertrophic obstructive cardiomyopathy (HOCM) remains unclear.
Methods:
A total of 423 HOCM patients (average BMI 25.4 ± 3.4 kg/m2) were recruited for our study. Participants were stratified into three groups based on BMI: normal weight (BMI < 23 kg/m2), overweight (BMI 23-27.5 kg/m2), and obesity (BMI ≥ 27.5 kg/m2).
Results:
Compared with normal weight, patients with obesity had significantly lower prevalence of syncope (p = 0.007) and moderate or severe mitral regurgitation (p = 0.014), and serum NT-proBNP (p = 0.004). Multiple linear regression analysis indicated that BMI (β = 0.328, p < 0.001), log NT-proBNP (β = 0.308, p < 0.001), presence of AF (β = 0.209, p = 0.001), and left ventricular diastolic diameter index (β = 0.142, p = 0.019) were independently related with LA diameter. However, BMI was not an independent predictor of the presence of AF on multivariable binary logistical regression analysis.
Conclusions:
BMI was independently associated with LA diameter; however, it was not an independent predictor of prevalence of AF. These results suggest that BMI may promote incidence of AF through LA enlargement in HOCM.
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