Obesity Modifies Clinical Outcomes of Right Ventricular Dysfunction

Area of Science:

• Cardiology
• Cardiovascular Diseases
• Obesity Medicine

Background:

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

Purpose of the Study:

• To investigate the association between obesity and hemodynamic indices of RV dysfunction.
• To examine how RV function and obesity interact to influence clinical outcomes such as mortality and heart failure hospitalizations.

Main Methods:

• A hospital-based cohort of 8285 patients undergoing right heart catheterization between 2005 and 2016 was analyzed.
• Linear regression assessed the relationship between body mass index and RV dysfunction indices (e.g., pulmonary artery pulsatility index, right atrial pressure:pulmonary capillary wedge pressure ratio, RV stroke work index).
• Cox models evaluated the association of RV function measures with mortality and heart failure hospitalizations, with interaction analyses for body mass index.

Main Results:

• Higher body mass index correlated with poorer RV function indices, including lower pulmonary artery pulsatility index and RV stroke work index, and a higher right atrium:pulmonary capillary wedge pressure ratio (P<0.001 for all).
• Over a median follow-up of 7.3 years, RV dysfunction was linked to increased mortality and heart failure hospitalizations.
• Body mass index significantly modified the association between RV dysfunction and all-cause mortality, with a more pronounced risk at higher body mass index levels (P_interaction≤0.005).

Conclusions:

• Obesity is associated with impaired hemodynamic measures of RV function in a large hospital-based cohort.
• RV dysfunction independently predicts adverse clinical outcomes, including mortality and heart failure hospitalizations.
• The adverse prognostic impact of RV dysfunction is significantly amplified in individuals with higher body mass index, highlighting obesity as a critical factor in cardiovascular risk stratification.