Abstract 16061: Correlation Between Obesity and Ventricular Tachycardia in Individuals With HFrEF: Analysis From the DERIVATE Cohort
Authors: Mosley Jackson L , Voruganti Dinesh , Sadaf Murrium I , Mansour Munthir , Spraggins Robert , Abouelenein Saly , Abete Raffaele , Aquaro Giovanni , Baggiano Andrea , Barison Andrea , Bogaert Jan , Camastra Giovanni , Carigi Samuela , Carrabba Nazario , Casavecchia Grazia , Censi Stefano , Cicala Gloria , De Cecco Carlo , De Lazzari Manuel , Di Giovine Gabriella , Calo Leonardo , Dobrovie Monica , Focardi Marta , Fusini Laura , Gaibazzi Nicola , Gismondi Annalaura , Gravina Matteo , Guglielmo Marco , Lanzillo chiara , lombardi massimo , Lorenzoni Valentina , Lozano Torres Jordi , Margonato Davide , Martini Chiara , Marzo Francesca , Masci Pier-Giorgio , Masi Ambra , Moro Claudio , Muscogiuri Giuseppe , Mushtaq Saima , Nese Alberto , Palumbo Alessandro , Pavon Anna Giulia , Pedrotti Patrizia , Perazzolo Marra Martina , Praadella Silvia , Presicci Cristina , Pontone Gianluca , Al'Aref Subhi J ,   on behalf of the DERIVATE Co-investigators
Published: December 2023

Background:
Ventricular arrhythmias (VA) are a significant cause of morbidity and mortality in heart failure. Obesity has been proposed as a potential risk factor for increased VA incidence, but previous studies with limited sample sizes and single-center enrollment have yielded conflicting results. To address this, we utilized data from the international multicenter DERIVATE study, which includes individuals with heart failure with reduced ejection fraction (HFrEF) as well as baseline cardiac MRI (CMR) assessment of myocardial structure and function. We sought to investigate the association between obesity and sustained ventricular tachycardia (VT) occurrence in this patient population.

Methods:
Study cohort comprised of patients enrolled in the CarDiac MagnEtic Resonance for Primary Prevention Implantable CardioVerter DefibrillAtor ThErapy (DERIVATE) registry who had HFrEF and had simultaneous baseline CMR and echocardiography evaluation. Demographics, comorbidities, and CMR variables were used to evaluate the correlation between obesity and ventricular tachycardia. Obesity was defined as BMI>30 kg/m
2
. A multivariate logistic regression analysis was used to determine the association between clinical, imaging variables and the occurrence of VA. Statistical software SAS 9.4 was used to perform the analysis.

Results:
Among 2,537 individuals, 505 (19.9%) were obese. Mean age was 60 years and 23.9% were female. Median follow-up was 994 days. Obesity was not associated with VT (OR 0.94, CI 0.60-1.48, P=0.79). The occurrence of VT was associated with the presence of an ischemic cardiomyopathy (OR 1.76, CI 1.37-2.26, p<0.01), and amiodarone use (OR 1.89, CI 1.28-2.80, P<0.01). As expected, left ventricular ejection fraction was inversely associated with VT (OR 0.96, CI 0.94-0.98, P<0.01), while indexed left ventricular end diastolic volume was directly associated with VT (OR 1.01, CI 1.00-1.01, P<0.01).

Conclusions:
In individuals with HFrEF, there was no association between obesity and the occurrence of sustained VT. The presence of ischemic cardiomyopathy was associated with higher incidence of sustained VT, as well as larger indexed left ventricular end diastolic volume which is an imaging marker of HF chronicity and severity.