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Cited by 94Cardiovascular and exercise physiologyHeart Failure Treatment and ManagementCardiac Health and Mental Health

The prognostic value of body mass index and standard exercise testing in male Veterans with congestive heart failure

Lissin, Lynette W., Gauri, Andre J., Froelicher, Victor F., Ghayoumi, Afshin, Myers, Jonathan, Giacommini, John·2002·Journal of Cardiac Failure
DOI 10.1054/jcaf.2002.126812
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Abstract

Objective To evaluate the prognostic characteristics of body mass index (BMI) and standard exercise test variables in a consecutive series of patients with mild to moderate congestive heart failure (CHF) referred for standard exercise tests.Background Controversy exists regarding the prognostic importance of BMI, etiology, and exercise test variables in patients with CHF.Methods All patients referred for evaluation at two university-affiliated Veterans Affairs Medical Centers who underwent treadmill tests for clinical indications between 1987 and 2000 were determined to be dead or alive using the Social Security Death Index after a mean 6 years follow-up. Clinical and exercise test variables were collected prospectively according to standard definitions; testing and data management were performed in a standardized fashion using a computer-assisted protocol. Survival analysis was performed using all-cause mortality as the endpoint for follow-up.Results A total of 522 patients with a history and clinical findings of CHF underwent exercise testing. Forty-two percent died during the follow-up period, for an average annual mortality of 6.7%. Cox proportional hazards model chose peak metabolic equivalents (METs), BMI, age, and ischemic etiology in rank order as independently and significantly associated with time to death. A score based on these variables classified patients into low (2% annual mortality), medium (5.2%), and high-risk groups (7% annual mortality).Conclusion Standard exercise testing and BMI can be used to estimate prognosis in outpatients with heart failure. A score incorporating METs, BMI, age, and etiology efficiently stratified these patients. BMI was chosen by the survival analysis, confirming its surprising inverse relationship to prognosis in CHF patients (i.e., heavier patients do better).

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  • A growing number of recent reports document a statistically significant survival benefit in obese patients once they have been diagnosed with cardiovascular diseases.

    “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 [211]

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Authors
Lissin, L. W., Gauri, A. J., Froelicher, V. F., Ghayoumi, A., Myers, J., & Giacommini, J.
Affiliations
  • Stanford Medicine (US)
  • VA Palo Alto Health Care System (US)
ORCID
Venue
Journal of Cardiac Failure
Publisher
Elsevier BV
Published
2002-08
Volume
8
Issue
4
Pages
206-215
ISSN
1071-9164 (ISSN-L)
DOI
10.1054/jcaf.2002.126812
OpenAlex
W2159394799
Cited by
94
References
48
Citations by year
2024: 1 · 2023: 1 · 2022: 1 · 2021: 1 · 2020: 1 · 2019: 2 · 2017: 5 · 2016: 6 · 2014: 5 · 2013: 4 · 2012: 4
FWCI
12.13
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Journal of Cardiac Failure (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
Keywords
congestive heart failure, body mass index, exercise testing, treadmill exercise testing, prognostic factors, all-cause mortality, peak metabolic equivalents, risk stratification, veterans, obesity paradox
MeSH terms
Aerospace Medicine, Age Factors, Aged, Angina Pectoris, California, Exercise Test, Follow-Up Studies, Heart Failure, Humans, Male, Middle Aged, Military Personnel, Cardiomyopathies, Prognosis, Risk Factors, Time Factors, Veterans, Body Mass Index, Prevalence, Multivariate Analysis, Proportional Hazards Models, Survival Analysis

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