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(Circulation. 2008;118:S_1153.)
© 2008 American Heart Association, Inc.

Obesity: Cardiac Imaging

Abstract 5157: Disparate Effects of Left Ventricular Geometry and Obesity on Mortality in Women with Preserved Systolic Function-The "Obesity Paradox" in Women

Dharmendrakumar Patel; Carl J Lavie; Richard Milani; Surya Artham; Hector Ventura

Ochsner Clinic Foundation, New Orleans, LA

Background: LV geometry predicts CV events. Although obesity is a risk factor for CV diseases, studies demonstrate a paradox regarding obesity and prognosis. To our knowledge no studies have determined the impact of LV geometry on mortality by obesity status in women with preserved EF.

Methods: We evaluated 26,216 female patients with preserved EF, including 10,465 obese (BMI 30; age: 58.4 ± 14.1 yr) as well as 15,661 non-obese women (BMI < 30; age: 63.2 ± 16.9 yr) to determine the impact of LV geometry on mortality during an average follow-up of 1.7±1.0 yr.

Results: Abnormal LV geometry occurred more commonly in obese than non-obese females (47% vs 39%, p<0.0001 for difference in the four patterns). In obese females, concentric remodeling was the most prevalent abnormal pattern (30%), with eccentric and concentric hypertrophy occurring in 7% and 10%, respectively, compared with non-obese patients (25%, 6%, and 8% respectively). Overall mortality was considerably lower in obese than non-obese (5.6% vs 8.7%, p<0.0001), but mortality increased with abnormal LV geometry (Figure). In both groups, higher age, relative wall thickness, and LV mass index were independent predictors of mortality. Higher BMI was associated with lower mortality [HR: 0.93 (0.92 – 0.94), p<0.0001] in non-obese whereas in obese was associated with higher mortality [HR: 1.03 (1.02 – 1.04), p<0.0001].

Conclusion: Although an obesity paradox exists, in that obesity is associated with higher prevalence of structural abnormalities but lower mortality, LV geometric abnormalities are prevalent in obese and non-obese females with preserved systolic function and are associated with increased mortality in both groups.

Mortality Prevalence in four LV Geometry By Obesity status in Females (n=26, 216)

This Article Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Request Permissions Google Scholar Articles by Patel, D. Articles by Ventura, H. PubMed Articles by Patel, D. Articles by Ventura, H.