Abstract
One of the purposes of cardiac rehabilitation (CR) after acute coronary syndrome (ACS) is to monitor and control weight of the patient. Our study is to compare the different obesity indexes, body mass index (BMI), and waist circumference (WC), through one well-designed CR program (CRP) with ACS in Guangzhou city of Guangdong Province, China, in order to identify different effects of BMI and WC on organ damage. In our work, sixty-one patients between October 2013 and January 2014 fulfilled our study. We collected the vital signs by medical records, the clinical variables of body-metabolic status by fasting blood test, and the organ damage variables by submaximal exercise treadmill test (ETT) and ultrasonic cardiogram (UCG) both on our inpatient and four-to-five weeks of outpatient part of CRP after ACS. We mainly used two-tailed Pearson's test and liner regression to evaluate the relationship of BMI/WC and organ damage. Our results confirmed that WC could be more accurate than BMI to evaluate the cardiac function through the changes of left ventricular structure on the CRP after ACS cases. It makes sense of early diagnosis, valid evaluation, and proper adjustment to ACS in CRP of the obesity individuals in the future.
Highlights
Obesity usually caused a variety of structural adaptations/ alterations that could largely damage cardiovascular structure/function [1]
There were no significant differences of age, gender, smoking, diabetes, dyslipidemia, left main disease (LMD), three-vessel disease (TVD), and complicated coronary artery disease (CCAD) in the two groups regardless of being stratified by Body mass index (BMI) or waist circumference (WC) standard
Our study presented that BMI is more strongly associated with hypertension than WC and the reasons might be as follows: (1) the gender gap existed in our study (93.3% males gender), and the population characteristics showed that overweight/obesity individual assessed by BMI is more statistically significant with hypertension than WC; (2) it was restricted on the outcomes to use the single blood pressure (BP) measurement, and it will be more accurate to use
Summary
Obesity usually caused a variety of structural adaptations/ alterations that could largely damage cardiovascular structure/function [1]. Gruberg et al have found the obesity paradox phenomenon, which is the fact that obese patients seemed to survive better in cardiovascular disease populations [9, 10]. One possible explanation of that is that the popular index of general obesity, BMI, might not be able to accurately reflect the distribution of body fat and fat free mass (FFM) [11,12,13,14]. The increase of body fat is easier to cause CVD than FFM because of metabolic abnormalities [1]. Waist circumference (WC), a common index to diagnose central obesity, can better reflect body fat than BMI. WC has been associated with an increased risk of mortality in patients with CVD [15]; it might be significant to the prognosis of heart disease. WC has been associated with an increased risk of mortality in patients with CVD [15]; it might be significant to the prognosis of heart disease. de Koning et al reported
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