Lower body surface area (<1.78 m2) was associated with higher 1-year mortality compared to the highest quartile (>2.07 m2) in chronic heart failure (HR 1.823; 95% CI 1.398-2.376; P<0.001).
Observational (n=9,104)
Yes
Does body surface area predict mortality and heart failure hospitalizations in patients with chronic heart failure?
Lower body surface area is independently associated with higher all-cause and cardiovascular mortality, but not heart failure hospitalizations, in patients with chronic heart failure, extending the concept of the 'obesity paradox'.
Effect estimate: HR 1.823 (95% CI 1.398-2.376)
p-value: p=< 0.001
AIMS: The 'obesity paradox' is consistently observed in patients with heart failure (HF). We investigated the relationship of body surface area (BSA) to mortality and hospitalizations in patients with chronic HF. METHODS AND RESULTS: Data from the outpatient cohort of the observational, prospective, Heart Failure Long-Term Registry of the Heart Failure Association of the European Society of Cardiology was analysed in order to evaluate the prognostic significance of BSA in chronic HF. A total of 9104 chronic HF patients (age 64.8 ± 13.4 years; 71.6% males) were enrolled. Mortality during 1-year follow-up was observed in 718 of 8875 (8.1%) patients. A progressive, inverse relationship between all-cause mortality and BSA levels was observed; the adjusted hazard ratio (HR) for 1-year mortality was 1.823 95% confidence interval (CI) 1.398-2.376, P 2.07 m(2) ). For each increase of 0.1 m(2) in BSA, an adjusted HR of 0.908 (95% CI 0.870-0.948), P < 0.001 for mortality was calculated. HF hospitalizations were not associated with BSA subgroup distribution. In both genders, subjects within the lowest BSA quartile (males <1.84 m(2) and females <1.64 m(2) ) had significantly higher mortality rates during follow-up (log-rank P < 0.0001). However, the stepwise association with mortality was more distinct in males. CONCLUSIONS: Total and cardiovascular mortality, but not HF hospitalizations was inversely associated with BSA levels in chronic HF patients. BSA may serve as a prognostic indicator for adverse outcome in HF patients.
Zafrir et al. (Sun,) conducted a observational in chronic heart failure (n=9,104). Body surface area (BSA) vs. Highest quartile (BSA >2.07 m2) was evaluated on 1-year all-cause mortality (HR 1.823, 95% CI 1.398-2.376, p=< 0.001). Lower body surface area (<1.78 m2) was associated with higher 1-year mortality compared to the highest quartile (>2.07 m2) in chronic heart failure (HR 1.823; 95% CI 1.398-2.376; P<0.001).
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