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Related Concept Videos

Drug Dosing: Obese Patients01:21

Drug Dosing: Obese Patients

30
In the United States, obesity is a prominent concern. It is linked to heightened mortality rates due to increased occurrences of conditions such as hypertension, atherosclerosis, coronary artery disease, and diabetes compared to nonobese individuals. A patient is classified as obese if their actual body weight surpasses the ideal or desirable body weight by 20%, based on Metropolitan Life Insurance Company data. Ideal body weights consider average weights and heights for males and females...
30
Pharmacokinetics in Obese Patients: Drug Absorption and Distribution01:25

Pharmacokinetics in Obese Patients: Drug Absorption and Distribution

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Obesity significantly alters the pharmacokinetic processes of drug absorption and distribution, presenting unique challenges in medical treatment. The increased fat tissue and decreased lean muscle in obese individuals can significantly affect how drugs are absorbed into the body and distributed across different tissues. This alteration can lead to variances in the effectiveness and safety of medications, necessitating adjustments in dosing or drug selection for obese patients.One notable...
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Aortic Regurgitation III: Medical Management01:25

Aortic Regurgitation III: Medical Management

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Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
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Pharmacokinetics in Obese Patients: Drug Metabolism and Excretion01:20

Pharmacokinetics in Obese Patients: Drug Metabolism and Excretion

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Drug metabolism, a critical process in the liver, involves two primary phases: Phase I reactions and Phase II conjugation. Obesity introduces significant alterations in this metabolic process, primarily due to fatty infiltration of the liver, leading to conditions such as nonalcoholic fatty liver disease (NAFLD). This condition can modify the activities of both Phase I and II enzymes, impacting how drugs are metabolized in obese patients.Phase I metabolism sees variable effects across...
31

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Related Experiment Video

Updated: Oct 23, 2025

Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
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Does "Obesity Paradox" Apply for Patients Undergoing Transcatheter Aortic Valve Replacement?

Marouane Boukhris1, Jessica Forcillo2, Jeannot Potvin2

  • 1Division of Cardiology and Cardiac Surgery, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, Quebec, Canada; Department of Cardiology, Dupuytren University Hospital, Limoges, France.

Cardiovascular Revascularization Medicine : Including Molecular Interventions
|August 20, 2021
PubMed
Summary

Investigating the obesity paradox in Transcatheter Aortic Valve Replacement (TAVR) patients, this study found body mass index (BMI) is a prognostic tool for short-term mortality. Underweight patients (BMI <20 kg/m²) had higher 30-day mortality, but no obesity paradox was observed.

Keywords:
Body mass indexMortalityOutcomesTAVR

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Area of Science:

  • Cardiology
  • Metabolic Health
  • Geriatric Medicine

Background:

  • Controversy exists regarding the
  • obesity paradox
  • in patients undergoing Transcatheter Aortic Valve Replacement (TAVR).
  • Body Mass Index (BMI) prognostic value in TAVR outcomes is debated.

Purpose of the Study:

  • To investigate the prognostic value of Body Mass Index (BMI) on patient outcomes following Transcatheter Aortic Valve Replacement (TAVR).
  • To determine if an
  • obesity paradox
  • exists in the TAVR population.

Main Methods:

  • Observational, single-center study of 412 patients undergoing TAVR (2009-2019).
  • Patients categorized into four BMI groups: underweight (<20 kg/m²), normal weight (20-24.9 kg/m²), overweight (25-29.9 kg/m²), and obese (≥30 kg/m²).
  • Primary endpoints: all-cause 30-day and one-year mortality.

Main Results:

  • Underweight patients (8.5%) were older with higher STS scores and comorbidities.
  • Higher BMI trended toward lower 30-day mortality (HR 0.87, p=0.071), with underweight patients showing higher 30-day mortality (8.3%, p=0.045).
  • No significant difference in one-year mortality or survival between BMI groups was observed; no obesity paradox found for 30-day survivors.

Conclusions:

  • Body Mass Index (BMI) may serve as a prognostic tool for short-term mortality in TAVR patients.
  • Underweight (BMI <20 kg/m²) is associated with increased 30-day mortality.
  • No evidence of an obesity paradox was observed in this TAVR cohort for 30-day survivors.