Relationships between Weight, Adiposity, Functional Status, and Left Ventricle Characteristics in Overweight and Obese Patients with Heart Failure.

Aims: This study was conducted to examine the relationship between adiposity and functional status (i.e. peak oxygen consumption [VO₂max]), and left ventricular (LV) structural characteristics (i.e., LV ejection fraction [LVEF], LV end diastolic dimension [LVEDD], LV posterior wall thickness [LVPWT]) in heart failure (HF) patients with diabetes mellitus (DM), and/or metabolic syndrome (MS). We hypothesize that excess weight and body fat are significantly related to cardiac functional status.

Methods and results: Ninety four patients' clinical characteristics were analyzed at baseline to examine the relationships of interest. Results show that weight was correlated with fat and lean mass and LVEF (all p's < 0.050). Novel findings from our data showed that weight, fat mass, and percent fat were inversely related to VO₂max; weight, fat mass and lean mass were positively related with LVPWT. In a multivariate analysis, body mass index and fat mass accounted for 28.8% of the variance in VO₂max, showing significantly higher predictive value than other covariates (P = 0.002).

Conclusions: Our findings show a possible relationship between body fat on functional status in this patient cohort and challenges existing research that supports that higher weight and increased fat are good in the setting of chronic HF (i.e. obesity paradox). Strategies to optimize weight and reduce adiposity warrants further investigation in this subgroup of patients.