Obesity Modifies Clinical Outcomes of Right Ventricular Dysfunction

Area of Science:

• Cardiology
• Obesity Medicine
• Cardiovascular Imaging

Background:

• Right ventricular (RV) dysfunction is a significant predictor of mortality in various cardiovascular diseases.
• The impact of obesity on RV function and associated clinical outcomes remains incompletely understood.

Approach:

• A hospital-based cohort of 8285 patients undergoing right heart catheterization (2005-2016) was analyzed.
• Linear regression assessed the association between body mass index (BMI) and hemodynamic indices of RV dysfunction.
• Cox models evaluated the relationship between RV function and clinical outcomes, including mortality and heart failure hospitalizations.

Key Points:

• Higher BMI correlated with poorer RV function indices, including lower pulmonary artery pulsatility index (PAPi) and RV stroke work index (RVSWI), and a higher right atrial pressure:pulmonary capillary wedge pressure ratio (RAP:PCWP).
• RV dysfunction was linked to increased risks of mortality and heart failure hospitalization.
• Body mass index (BMI) significantly modified the association between RV dysfunction and adverse outcomes, amplifying the risk in individuals with higher BMI.

Conclusions:

• Obesity is associated with impaired hemodynamic measures of RV function in a large hospital-based population.
• While RV dysfunction independently predicts worse clinical outcomes, its detrimental effect is substantially magnified in patients with obesity.