Abstract P286: The Impact of Obesity Severity on Left Ventricular Mass Index in Adults With Congenital Heart Disease

Abstract

Introduction: Obesity is a global epidemic. Adult congenital heart disease (ACHD) patients are obese at rates comparable to the general population. Obesity is associated with left ventricular hypertrophy (LVH) which can be assessed by LV mass index [LVMI = LVM/Ht 2.7 (g/m 2.7 )]. Elevated LVMI is known to be associated with adverse cardiovascular events in non-CHD populations, however, there is a paucity of data on the relationship of obesity severity and the rate and extent of LVH in ACHD. Hypothesis: The rate and extent of LVH in a cohort of obese ACHD patients will increase as obesity class increases. Methods: We reviewed transthoracic echocardiogram data including LVMI, BMI, and blood pressure in obese, repaired, ACHD patients 18+ years of age from 2012-2020. Patients were grouped by sex and NIH/WHO obesity class and LVMI was analyzed. Outcome differences were assessed using one-way ANOVA (p < 0.05 = statistically significant). Results: We included 386 patients, 202 of whom were female, as seen in Table 1. There were no blood pressure differences between obesity classes (P = 0.18). LVMI was higher with increasing obesity class (42.4±13.5 g/ht 2.7 vs 43.6±12.7 g/ht 2.7 vs 48.9±13.2 g/ht 2.7 respectively, P = 0.004 for females and 45.9±12.8 g/ht 2.7 vs 48.9±13.8 g/ht 2.7 vs 55.3±16.8 g/ht 2.7 , P = 0.019 for males). For females, 36.4% of class I, 31.9% of class II, and 58.3% of class III met LVH criteria ≥ 47 g/ht 2.7 . For males, 29.9% of class I, 44.4% of class II, and 59.4% of class III met LVH criteria ≥ 51 g/ht 2.7 . Conclusion: Obesity severity correlates with progressive LVMI and LVH in ACHD patients. Elevated LVMI is most striking in patients with class III obesity. This highlights the potential negative impact of obesity in this population and additionally suggests that even in obese patients, prevention of progression to class III obesity may help prevent deleterious cardiac changes. Further research is needed regarding how this association impacts this high-risk population.