Effect of obesity on cardiac morphological changes and clinical prognosis in patients with hypertrophic cardiomyopathy

Abstract

Objective To investigate the relationship between body mass index (BMI) and cardiac morphological changes and clinical prognosis in patients with hypertrophic cardiomyopathy (HCM). Methods Clinical and followed up data of patients with HCM hospitalized in DrumTower Clinical Medical College of Nanjing Medical University from January 2010 to December 2015 were retrospectively analyzed. Major cardio-cerebral vascular adverse events (MACCE), including cardiac death, exacerbation of re-admission and stroke) were set as primary endpoints. Patients were divided into normal body group [body mass index (BMI) < 24 kg/m2], pre-obesity group (24 kg/m2 ≤ BMI < 28 kg/m2), and obese group (BMI ≥ 28 kg/m2). Baseline characteristics of each group and the occurrence of MACCE were compared. Results All of 206 patients were followed up for (50.4 ± 18.6) months. Twenty-nine patients (14.1%) died during follow-up, and cardiac death occured in 17 patients (8.2%) including 4 patients with cardiac arrrest,11 patients with heart failure. With the increase of BMI, there was no significant difference in left ventricular mass index (LVMI), but left atrium dimension (LAD), left ventricular end diastolic dimension(LVDd) and left ventricular mass (LVM) showed a significant upward trend.Single risk factor analysis indicated that coronary heart disease, NYHA ≥ Ⅲ, chronic heart failure duration > 1 year, atrial fibrillation, BMI, LAD, left ventricular ejection fraction (LVEF), LVM, LVMI were correlated with MACCE. Multifactor analysis showed that BMI (OR=1.335, P=0.006) and NYHA ≥ Ⅲ (OR=3.513, P=0.046) were independent risk factors for MACCE in HCM patients. Conclusions BMI is significantly associated with MACCE in HCM patients. Weight management is particularly important for patients with HCM. Key words: Cardiomyopathy,hypertrophic; Prognosis; Risk factors