Relationships between Weight, Adiposity, Functional Status, and Left Ventricle Characteristics in Overweight and Obese Patients with Heart Failure

Journal of Diabetes and Obesity Research Article Open Access Relationships between Weight, Adiposity, Functional Status, and Left Ventricle Characteristics in Overweight and Obese Patients with Heart Failure Marjan Motie 1* , Lorraine S. Evangelista 1 , Dawn Lombardo 2 , Tamara B. Horwich 3 , Michele Hamilton 4 , Gregg C. Fonarow 5 Program in Nursing Science, University of California Irvine, Irvine, California, USA Department of Medicine, University of California Irvine Medical Center, Irvine, California, USA University of California at Los Angeles, David Geffen School of Medicine, Los Angeles, California, USA Department of Medicine/Cardiology UCLA and Director of the Heart Failure Program, Cedars-Sinai Heart Institute, Los Angeles, California, USA Director, UCLA Cardiomyopathy Center and Professor of Cardiology, David Geffen School of Medicine, Los Angeles, California, USA Corresponding author: Marjan Motie, PhD, Assistant Professional Researcher, UCI Program in Nursing Science, Irvine, CA 92697, California, USA, Tel: (949) 824-8707/ (714) 393-9292; E-mail: mmotie@hs.uci.edu Abstract Aims: This study was conducted to examine the relationship between adiposity and functional status (i.e. peak oxygen consumption [VO 2 max]), and left ventricular (LV) structural characteristics (i.e., LV ejection fraction [LVEF], LV end diastolic dimen- sion [LVEDD], LV posterior wall thickness [LVPWT]) in heart failure (HF) patients with diabetes mellitus (DM), and/or metabolic syndrome (MS). We hypothesize that excess weight and body fat are significantly related to cardiac functional status. Methods and Results: Ninety four patients’ clinical characteristics were analyzed at baseline to examine the relationships of interest. Results show that weight was correlated with fat and lean mass and LVEF (all p’s < 0.050). Novel findings from our data showed that weight, fat mass, and percent fat were inversely related to VO 2 max; weight, fat mass and lean mass were positively related with LVPWT. In a multivariate analysis, body mass index and fat mass accounted for 28.8% of the variance in VO 2 max, showing significantly higher predictive value than other covariates (P = 0.002). Conclusions: Our findings show a possible relationship between body fat on func- tional status in this patient cohort and challenges existing research that supports that higher weight and increased fat are good in the setting of chronic HF (i.e. obesity paradox). Strategies to optimize weight and reduce adiposity warrants further inves- tigation in this subgroup of patients. Received Date: September 08, 2016 Accepted Date: February 13, 2017 Published Date: February 20, 2017 Citation: Motie, M., et al. Relationships between Weight, Adiposity, Functional Status, and Left Ventricle Characteristics in Overweight and Obese Patients with Heart Failure. (2017) J diab Obes 4(2): 1-5. DOI: 10.15436/2376-0494.17.1108 Keywords: Heart failure, Functional status, Left ventricular characteristics, Obesity Introduction ing that obesity affects the structure and function of the heart mainly by causing increased blood volume, elevated cardi- ac output, left ventricular (LV) hypertrophy, and LV diastol- ic dysfunction all of which also play a role in causing HF [6] . Recent literature has described the relationship be- tween obesity and overweight with several obesity related com- plications (e.g., cardiac functional status, LV characteristics) [7] ; however, these relationships are even less well defined in pa- tients with HF and multiple co-morbidities (e.g., obesity, DM, metabolic syndrome [MS]). Prior research has not been able to distinctly identify the effects of obesity from the effects of the comorbidities which on their own cause LV dysfunction. Fur- thermore, despite the known deleterious effects of excess body weight as an independent risk factor for cardiovascular disease (CVD), there are multiple studies showing improved survival in obese patients with known CVD (concept known as obesity par- Chronic heart failure (HF) is a healthcare epidemic characterized by progressive decline of cardiac performance and continues to be a public health problem affecting over 5 million Americans [1] . Chronic HF is associated with significant comor- bidities and frequent decompensation, resulting in recurrent hos- pitalizations [2,3] . Being overweight or obese are well established comorbidities and/or risk factors that lead to health consequenc- es including coronary heart disease, hypertension, diabetes mel- litus (DM), dyslipidemia, sleep apnea, and certain cancers [4] . Obesity has been reported as affecting the cardio- vascular system directly in many ways, in addition to the in- direct consequences caused by the deleterious effects of the known comorbidities and their associated risk factors [5] . Many human and animal studies have led to the understand- Motie, M., et al. Copyrights: © 2017 Motie, M. This is an Open access article distributed under the terms of Creative Commons Attribution 4.0 International License. J Diabetes Obes Volume 4: Issue 2