Mahmoud Al Rifai, Maria Alwan, Ahmed Ibrahim Ahmed, Faisal Nabi, Ahmed Soliman, Jean Michel Saad, Sherif F Nagueh, Tariq Nabil, Khurram Nasir, Kershaw V Patel, John J Mahmarian, Mouaz H Al-Mallah
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引用次数: 0
Abstract
Background: Obesity is a major cardiovascular risk factor associated with coronary microvascular dysfunction, which can be non-invasively assessed using myocardial flow reserve (MFR) on positron emission tomography (PET). As impaired MFR identifies high-risk patients, we assessed whether body mass index (BMI) modifies the association between MFR and cardiovascular outcomes.
Methods: Consecutive patients with no known coronary artery disease who had a clinically- indicated PET were enrolled and followed prospectively for incident outcomes (all-cause death, major adverse cardiovascular events (MACE), and heart failure admissions). Multivariable-adjusted Cox proportional hazards models were used to study the association between MFR, and incident events stratified by BMI categories.
Results: The study population consisted of 3,397 patients; median (IQR) age 67 (59-74) years, 55.2% female, 63.9% White, 17.6% with a BMI of 18.5-<25 kg/m2, 27.5% with a BMI of 25-<30 kg/m2, 38.6% with a BMI of 30-<40 kg/m2, and 16.3% with a BMI of ≥40 kg/m2. The median (IQR) MFR was 2.35(1.96-2.80). Over a median (IQR) follow-up time of 1.34 (0.43-2.43) years, there were 125 incident events (56 MACE, 6 HF admissions, and 70 deaths). In adjusted analyses, a 0.1-unit increase in MFR was significantly associated with decreased incident outcomes; HR (95% CI):0.91 (95% CI 0.84-0.99) for BMI 18.5-<25 kg/m2, 0.88 (0.83-0.94) for BMI 25-<30 kg/m2, 0.93 (0.87-0.99) for BMI 30-<40 kg/m2, and 0.88 (0.76-1.01) for BMI ≥40 kg/m2. There was no significant interaction between MFR and BMI; p= 0.381.
Conclusion: PET-derived global MFR is inversely associated with subsequent cardiovascular outcomes in all BMI categories.
期刊介绍：
Journal of Nuclear Cardiology is the only journal in the world devoted to this dynamic and growing subspecialty. Physicians and technologists value the Journal not only for its peer-reviewed articles, but also for its timely discussions about the current and future role of nuclear cardiology. Original articles address all aspects of nuclear cardiology, including interpretation, diagnosis, imaging equipment, and use of radiopharmaceuticals. As the official publication of the American Society of Nuclear Cardiology, the Journal also brings readers the latest information emerging from the Society''s task forces and publishes guidelines and position papers as they are adopted.
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