The DOI matches its Crossref record; 30 of the 30 references it cites were found in a registry or an index.
The relationship between obesity and mortality in patients with heart failure
Open accessAbstract
Objectives The study aimed to evaluate the role of obesity in the prognosis of patients with heart failure (HF).Background Previous reports link obesity to the development of HF. However, the impact of obesity in patients with established HF has not been studied.Methods We analyzed 1,203 patients with advanced HF followed in a comprehensive HF management program. The patients were subclassified into categories of body mass index (BMI) defined as: underweight BMI <20.7 (n = 164), recommended BMI 20.7 to 27.7 (n = 692), overweight BMI 27.8 to 31 (n = 168) and obese BMI >31 (n = 179). This sample size allows the detection of small effects (0.02), with a power of 0.80 and an alpha level of 0.05 for comparing one-year survival between BMI groups.Results The four BMI groups had similar profiles in terms of ejection fraction (mean 0.22), sodium, creatinine and smoking. The obese and overweight groups had significantly higher rates of hypertension and diabetes, as well as higher levels of cholesterol, triglycerides and low density lipoprotein cholesterol. The four BMI groups had similar survival rates. Ejection fraction, HF etiology and angiotensin-converting enzyme inhibitor use predicted survival on univariate analysis (p < 0.01), although BMI did not. On multivariate analysis, cardiopulmonary exercise tests, pulmonary capillary wedge pressure and serum sodium were strong predictors of survival (p < 0.05). Higher BMI was not a risk factor for increased mortality, but was associated with a trend toward improved survival.Conclusions In a large cohort of patients with advanced HF of multiple etiologies, obesity is not associated with increased mortality and may confer a more favorable prognosis. Further studies need to delineate whether weight loss promotion in medically optimized patients with HF is a worthwhile therapeutic goal.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“Considering that some long-term studies have shown that weight loss in overweight and obesity is associated with increased mortality coupled with many CV studies showing a better prognosis with a higher BMI, it has been suggested that purposeful weight loss may not be beneficial and may even be detrimental in patients with CV diseases (31,66 -68).”
From Obesity and Cardiovascular Disease (2009) · cites this paper as [31]
In the citing paper
“While it is widely accepted that obesity increases the risk of developing heart disease, a growing number of recent reports document a statistically significant survival benefit in obese patients once they have been diagnosed with cardiovascular diseases (128, 144, 145, 200, 201, 211, 244).”
From Cardiac remodeling in obesity (2008) · cites this paper as [145]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
Hubert, H. B., Feinleib, M., McNamara, P. M., & Castelli, W. P. (1983) · Circulation · doi:10.1161/01.cir.67.5.968 · Cited by 4,241
Body-Mass Index and Mortality in a Prospective Cohort of U.S. Adults
Calle, E. E., Thun, M. J., Petrelli, J. M., Rodriguez, C., & Heath, C. W. (1999) · New England Journal of Medicine · doi:10.1056/nejm199910073411501 · Cited by 3,643
Wasting as independent risk factor for mortality in chronic heart failure
Anker, S. D., Ponikowski, P. P., Varney, S. J., Chua, T. P., Clark, A. L., Webb-Peploe, K., Harrington, D., Kox, W. J., Poole-Wilson, P. A., & Coats, A. J. S. (1997) · The Lancet · doi:10.1016/s0140-6736(96)07015-8 · Cited by 1,399
Hormones and Hemodynamics in Heart Failure
Schrier, R. W., & Abraham, W. T. (1999) · New England Journal of Medicine · doi:10.1056/nejm199908193410806 · Cited by 1,192
Willett, W. C., Dietz, W. H., & Colditz, G. A. (1999) · New England Journal of Medicine · doi:10.1056/nejm199908053410607 · Cited by 1,137
Kuczmarski, R. J., & Flegal, K. M. (2000) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/72.5.1074 · Cited by 705
Massie, B. M., & Shah, N. B. (1997) · American Heart Journal · doi:10.1016/s0002-8703(97)70173-x · Cited by 547
The endotoxin-lipoprotein hypothesis
Rauchhaus, M., Coats, A. J. S., & Anker, S. D. (2000) · The Lancet · doi:10.1016/s0140-6736(00)02690-8 · Cited by 544
Fonarow, G. C., Stevenson, L. W., Walden, J. A., Livingston, N., Steimle, A. E., Hamilton, M. A., Moriguchi, J. D., Tillisch, J. H., & Woo, M. A. (1997) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(97)00208-8 · Cited by 541
Self-citationEckel, R. H. (1997) · Circulation · doi:10.1161/01.cir.96.9.3248 · Cited by 512
Research works printed but not linked: 1
- Davos, 2000, Obesity and survival in chronic heart failure, Circulation, 102, I4202
Cited by
Sorted by citations
Items 801–866 of 866
Sharma, A. M. (2002) · doi:10.1002/9780470986882.ch19
Obesity – is it really so bad for a patient with coronary heart disease?
Pogorzelski, S., Kuźma, Ł., Struniawski, K., Wróblewski, D., Gajewska_Bachórzewska, H., & Dobrzycki, S. (2018) · Progress in Health Sciences · doi:10.5604/01.3001.0012.8346
Zan, M. C. D., Carrascosa, P., Reynoso, E., Deviggiano, A., Deschle, H., & Rodríguez-Granillo, G. A. (2019) · Archivos de cardiología de México · doi:10.24875/acm.m19000006
What is the Impact of Obesity in PH?
Park, M. (2010) · Advances in Pulmonary Hypertension · doi:10.21693/1933-088x-9.2.120
Relationship between left atrial dimensions and global and regional fat depots
Zan, M. C. D., Carrascosa, P., Reynoso, E., Deviggiano, A., Deschle, H., & Rodríguez-Granillo, G. A. (2019) · Archivos de cardiolog�a de M�xico (English ed Internet) · doi:10.24875/acme.m19000002
Cho, J. Y., & Kim, K. H. (2020) · International Journal of Heart Failure · doi:10.36628/ijhf.2019.0017
oCOm-21 as a Cardioprotective Inotrope Through S-Nitrosylation
Chau, A. Y. (2020) · Otago University Research Archive (University of Otago)
The Obesity Paradox Existing in Idiopathic Pulmonary Arterial Hypertension
Şentürk, B., Akdeniz, B., Özpelit, E., Yılmaz, M. B., Kahraman, B. Ö., Sezgin, D., Tertemiz, K. C., & Sevinç, C. (2020) · e-Journal of Cardiovascular Medicine · doi:10.32596/ejcm.galenos.2020.02.011
Obesity and Cardio-vascular Disorders: Review
Горбачова, В. В., & Plehutsa, О. І. (2020) · Family Medicine · doi:10.30841/2307-5112.3.2020.211860
Bariatric Surgery in Heart Failure
Belkin, M. N., & Blair, J. E. (2020) · Difficult decisions in surgery: an evidence-based approach · doi:10.1007/978-3-030-55329-6_7
Evaluating the effectiveness of brief behaviour change counselling in a primary care facility
Ganzevoort, J. (2020) · SUNScholar (Stellenbosch University)
Diagnosis and prognosis in connective tissue disease associated pulmonary hypertension
Benjamin, ., & Schreiber, E. (2013)
Effect of Obesity on Cardiovascular System: Literature Review
Sneineh, M. A. (2021) · Open access journal of clinical surgery · doi:10.51931/oajcs.2021.02.000021
Correlation of body mass index and pulmonary hypertension in patients with obstructive sleep apnoea
Mishra, S. K., Srivastava, G. N., Mishra, J. K., & Oli, R. (2021) · The Journal of Community Health Management · doi:10.18231/j.jchm.2021.018
Li, Y., Zhou, H., Xiang, Y., Zheng, J., Zhang, F., Xu, M., & Li, H. (2020) · doi:10.21203/rs.3.rs-38306/v1
Cardiovascular Disease Prevention in Women
Russell, C. E., Rodríguez, F., & Foody, J. M. (2014) · Springer eBooks · doi:10.1007/978-3-642-37393-0_56-1
Obesity and Associated Complications
Greenway, F. L., & Hamilton, M. (2004) · CRC Press eBooks · doi:10.1201/9780203508756.pt2
Self-citationPorubän, T., Bánovčinová, A., Vachalcová, M., Sieradzka, A. K., Jakubová, M., Schusterová, I., & Barkai, L. J. (2021) · Austin Journal of Clinical Cardiology · doi:10.26420/austinjclincardiolog.2021.1084
Extension of Healthy Life Span of Dialysis Patients in the Era of a 100-Year Life
Inaba, M., & Mori, K. (2021) · MDPI eBooks · doi:10.3390/books978-3-0365-2345-3
Rich, M. W. (2004) · Humana Press eBooks · doi:10.1007/978-1-59259-391-0_18
Simpson, J., & Gardner, R. S. (2022) · doi:10.1093/med/9780198766223.003.0028
Clark, A. L. (2022) · Oxford University Press eBooks · doi:10.1093/med/9780198766223.003.0002
Cardiac rehabilitation and chronic heart failure
Piepoli, M. F., & Clark, A. L. (2022) · doi:10.1093/med/9780198766223.003.0057
Gómez-González, M. N. (2022) · International Journal of Medical Science and Clinical Research Studies · doi:10.47191/ijmscrs/v2-i9-19
Adapting Tools of Causality to Analyze the Obesity ParadoxPreprint
Mitra, P., Zhang, X., & Heaton, C. (2023) · Research Square · doi:10.21203/rs.3.rs-2515102/v1
Liu, L., Zhu, Y., Oyenubi, O., Murad, M. H., & Jesmajian, S. (2023) · medRxiv · doi:10.1101/2023.05.12.23289919
Hu, Y., Gu, Z.-B., Xu, M., He, W., Wu, L., Xu, Z., & Guo, L. (2023) · Heliyon · doi:10.1016/j.heliyon.2023.e16515
Obesity: Central Role in Heart Failure With Preserved Ejection Fraction?
Pelter, M. N., & Horwich, T. B. (2023) · Mayo Clinic Proceedings · doi:10.1016/j.mayocp.2023.08.018
Self-citationZhuang, Z., Yao, M., Wong, J. Y. Y., Liu, Z., & Huang, T. (2021) · Figshare · doi:10.6084/m9.figshare.14509924
Milyukov, V. E., Александрович, Б. В., & Cuong, N. C. (2024) · Kardiologiia · doi:10.18087/cardio.2024.3.n2469 · Cited by 2
Hashemzadeh, M., Moghadam, A. S., Moghadam, S. S., & Movahed, M. R. (2024) · medRxiv · doi:10.1101/2024.08.17.24312157
The Impact of Body Mass Index on Morbidity and Mortality in Iraqi Patients With Heart Failure
Abdulhameed, A., Allami, M., & Dubais, H. M. (2024) · Cureus · doi:10.7759/cureus.71043
Yu, Z., Chen, Y., Miranda, O., Qi, M., Zhang, M., Feng, N., Ryan, T. P., Schloot, N. C., Chen, Y., Sam, F., et al. (2024) · medRxiv · doi:10.1101/2024.11.08.24317010
The Roles of Nutrition, Frailty, and Age
Bhat, G., & Yost, G. L. (2024) · Springer eBooks · doi:10.1007/978-3-030-86172-8_27-1
Movahed, M. R., Mineer, A., & Hashemzadeh, M. (2025) · Future Cardiology · doi:10.1080/14796678.2025.2477421 · Cited by 1
Zhang, J., Dong, B., Li, J., Ning, Y., Wang, Y., Huang, J., Zhu, W., Zhen, Z., Liang, W., Wei, F., et al. (2025) · Research Square · doi:10.21203/rs.3.rs-6203913/v1
Kou, L., Meng, F., Fu, G., & Zhang, R. (2025) · Cardiovascular Toxicology · doi:10.1007/s12012-025-10041-3
Obesity and Heart Failure: The (Fried) Chicken or the Egg?
Foster, L., Byrne, K. P. A., & Rivett, G. (2025) · Journal of Cardiothoracic and Vascular Anesthesia · doi:10.1053/j.jvca.2025.08.046
Impact of recipient body mass index on heart transplantation outcomes
Masroor, M., Jiang, C., Xiong, T., Wang, Y., & Dong, N. (2025) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2025.1573589
Nutritional assessment and management in pediatric heart failure
Ravishankar, C. (2025) · Elsevier eBooks · doi:10.1016/b978-0-443-13279-7.00011-0
Heart Failure in Obesity Hypoventilation Syndrome
Battaglia, E., & Compalati, E. (2025) · Noninvasive ventilation. The essentials · doi:10.1007/978-3-031-97449-6_40
Nakahashi, T., Sakata, K., Masuda, J., Kumagai, N., Higuma, T., Ogimoto, A., Tanigawa, T., Hanada, H., Nakamura, M., Takamura, M., et al. (2025) · International Heart Journal · doi:10.1536/ihj.25-135
Ingle, L., Rigby, A. S., Carroll, S., Butterly, R., King, R. F., Cooke, C. B., Cleland, J. G. F., & Clark, A. L. (2007) · PubMed Central
Ngew, K. Y., Tay, H. Z., & Yusof, A. K. M. (2024) · Figshare · doi:10.6084/m9.figshare.26637546
Zhuang, Z., Yao, M., Wong, J. Y. Y., Liu, Z., & Huang, T. (2021) · Figshare · doi:10.6084/m9.figshare.14509927
Cardiac Rehabilitation in Heart Failure
Piepoli, M. (2025) · Springer eBooks · doi:10.1007/978-3-031-95754-3_10
Kim, M., Lee, J., Yang, T., Oh, J., Kang, S., & Lee, C. J. (2026) · International Journal of Obesity · doi:10.1038/s41366-025-01923-1
Beyond BMI: why heart failure trials must quantify adiposity, not just obesity
Bayés‐Genís, A., & Schiattarella, G. G. (2026) · European Journal of Heart Failure · doi:10.1093/ejhf/xuag046
Gergely, T. G., Forrai, Z., Kazay, Á., Schäffer, P. P., Vámos, M., Pilecky, D., Füzesi, T. P., Hanuska, L. F., Nyolczas, N., Dékány, M., et al. (2026) · Clinical Research in Cardiology · doi:10.1007/s00392-026-02865-y
Sex- and phenotype-specific prognostic implications of body mass index in acute heart failure
Won, Y. S., Shin, M.-S., Kim, E., Chung, W.-J., Kim, E. J., Han, S., Park, S., Kim, H.-S., Lee, J.-H., Ahn, H., et al. (2026) · ESC Heart Failure · doi:10.1093/eschf/xvag050
New biomarkers and therapeutic targets in left ventricular hypertrophy
Evaristi, M. F. (2017) · theses.fr (ABES) · doi:10.70675/0d048706z75d9z4ea2za46fz8f14c110ade5
Le rôle de la galanine dans le remodelage cardiaque
Timotin, A. (2017) · theses.fr (ABES) · doi:10.70675/32f3b46bzd7a8z4dacz9ba8z6c9e89e61682
Obesity and the Obesity Paradox in Heart Failure
Koos, A., Vyas, A., Catalfamo, V. J., Tutor, A. W., & Lavie, C. J. (2026) · Elsevier eBooks · doi:10.1016/b978-0-443-15734-9.00177-1
Liao, P., Feng, S., Li, W., & Lili, E. (2026) · Frontiers in Public Health · doi:10.3389/fpubh.2026.1767531
Inverse association between body mass index and abdominal aortic calcification based on NHANES
Wang, Y., Meng, J., Wang, L., & Zhang, J. (2026) · Journal of Cardiothoracic Surgery · doi:10.1186/s13019-026-04416-y
Balantrapu, S., Kokkinos, P. F., Samuel, I. B. H., Pittaras, A. E., Faselis, C. J., & MYERS, J. N. (2026) · Kidney Medicine · doi:10.1016/j.xkme.2026.101471
Win, M. L., & Lang, C. C. (2026) · European Cardiology Review · doi:10.15420/ecr.2026.39
Lu, L., Kamar, S. A., Palm, C. L., Scholte, N. T. B., Suthahar, N., Connelly, M. A., Hillege, H. L., Akkerhuis, K. M., Umans, V. A. W. M., de Boer, R. A., et al. (2026) · Circulation Heart Failure · doi:10.1161/circheartfailure.125.013971
Body Composition in Heart Failure: A Phenotype-Informed Framework for Assessment and Management
van der Hoef, C. C. S., ter Maaten, J. M., Meems, L. M. G., Gorter, T. M., Tromp, J., van Veldhuisen, D. J., & Voors, A. A. (2026) · Journal of Cardiac Failure · doi:10.1016/j.cardfail.2026.08.018
Obesity paradox in heart failure with and without diabetes mellitus: a retrospective cohort study
Kwon, O., Yoon, M., & Park, J. J. (2026) · Clinical Research in Cardiology · doi:10.1007/s00392-026-03007-0
LEE, Y., Kim, K. T., Kim, A. R., Hong, J. A., Hyun, J., Lee, S. E., Kim, M.-S., Jeon, E.-S., Choi, J.-O., Oh, J., et al. (2026) · JHLT Open · doi:10.1016/j.jhlto.2026.100703
Simple measurement popularizes sarcopenia evaluation in patients with heart failure
Narumi, T., Watanabe, T., & Kubota, I. (2015) · European Journal of Internal Medicine · doi:10.1016/j.ejim.2015.06.004
Cardiac Risk Factor Improvement Following Bariatric Surgery
Eisenberg, D., & Morton, J. M. (2014) · Springer eBooks · doi:10.1007/978-1-4939-1206-3_34
Metadata
- Authors
- Horwich, T. B., Fonarow, G. C., Hamilton, M. A., MacLellan, W. R., Woo, M. A., & Tillisch, J. H.
- Affiliations
- University of California, Los Angeles (US)
- Corresponding author
- Fonarow, Gregg C
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2001-09
- Volume
- 38
- Issue
- 3
- Pages
- 789-795
- ISSN
- 0735-1097 (ISSN-L)
- OpenAlex
- W2053715742
- Cited by
- 867
- References
- 30
- Citations by year
- 2026: 20 · 2025: 32 · 2024: 32 · 2023: 36 · 2022: 33 · 2021: 33 · 2020: 38 · 2019: 37 · 2018: 41 · 2017: 64 · 2016: 44 · 2015: 25 · 2014: 47 · 2013: 39 · 2012: 39
- FWCI
- 10.97
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Disease and Adiposity
- Keywords
- obesity, heart failure, mortality, body mass index, prognosis, survival, cardiopulmonary exercise testing, pulmonary capillary wedge pressure, serum sodium, weight loss, advanced heart failure
- MeSH terms
- Adult, Exercise Test, Female, Heart Failure, Hemodynamics, Humans, Male, Middle Aged, Obesity, Prognosis, Pulmonary Wedge Pressure, Regression Analysis, Body Mass Index
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review