Uncoupling between intravascular and distending pressures leads to underestimation of circulatory congestion in obesity
Key result
Severe obesity is linked to higher PCWP relative to NT-proBNP, underestimating circulatory congestion.
- P<0.01
- n=212
Why the study?
Patients with obesity often present with dyspnoea, and greater external restraint on the heart may alter relationships between intravascular pressures and wall stress markers.
Does severe obesity alter the relationship between non-invasive biomarkers of circulatory congestion and directly-measured hemodynamics in patients with unexplained dyspnea?
Population
212 subjects with unexplained dyspnoea undergoing cardiac catheterization with simultaneous echocardiography
Comparison
Severe obesity (BMI ≥35 kg/m 2) vs BMI <35 kg/m 2
Design
Observational study
Authors
Discussion
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Member takes
Implication
Noninvasive biomarkers may underestimate congestion in severe obesity; hypothesis-generating for refined markers in obese dyspnea.
Study Design
Type
Observational (n=212)
Structured PICO
Does severe obesity alter the relationship between non-invasive biomarkers of circulatory congestion and directly-measured hemodynamics in patients with unexplained dyspnea?
P
Population
212 subjects with unexplained dyspnea undergoing cardiac catheterization with simultaneous echocardiography (blood sampling performed in a subset of n=58)
I
Intervention
Severe obesity (BMI ≥35 kg/m²)
C
Comparator
Without severe obesity (BMI <35 kg/m²)
O
Outcome
Relationship between echocardiographic and blood biomarkers of circulatory congestion and directly-measured hemodynamics (PCWP and LVTMP)surrogate
Main Result
p-value: p=<0.01
Non-invasive hemodynamic markers underestimate circulatory congestion in patients with severe obesity due to uncoupling between cardiac wall stress and intravascular pressures.
Cite This Study
Obokata et al. (2021) conducted an observational in Unexplained dyspnoea (n=212). Severe obesity (BMI ≥35 kg/m2) vs. BMI <35 kg/m2 was evaluated on Relationship between pulmonary capillary wedge pressure and biomarkers (NT-proBNP, MR-proANP, troponin T, GDF-15) (p=<0.01). Severe obesity (BMI ≥35 kg/m2) was associated with higher PCWP relative to biomarkers like NT-proBNP compared to BMI <35 kg/m2 (p<0.01), leading to underestimation of circulatory congestion.