The Association Of Body Mass Index And Long-term Outcome After Cardiac Resynchronization Therapy In Patients With Chronic Heart Failure

Objective:To explore the impacts of baseline body mass index(BMI)on long-term outcome in patients with chronic heart failure(CHF)after cardiac resynchronization therapy(CRT)Methods:A total of 130 heart failure patients treated with CRT were divided i nto 3 groups according to baseline BMI from January 2008 and September 2015:low BMI group(<18.5kg/m2,n=21),normal-weight group(18.5-23.9kg/m2,n=75),overweight group(24.0～28.0kg/m2,n=34).At baseline and 6 months after C RT,the clinical and echocardiographic data were received.The survival rate of major cardiac adverse events(MACE,including death,heart transplantation and rehospitalization for worsening HF)and all-cause mortality was analyzed by u sing Kaplan-Meier curve among different BMI groups Multivariate Cox regressi on model was performed to reveal the independent predictive values of BMI f or major adverse events and all-cause mortality.Results:At baseline overweight patients had more diabetes mellitus and higher levels of hemoglobin and albumin than underweight patients(P<0.05).Oppositely,patients with low BMI were more likely to have higher NYHA class and the level of brain natriuretic peptide.Overweight and Normal patients were well-tolerated to ACEI/ARB than underweight patients(P<0.05).Overweight patients were tended to have better echocardiographic improvements(including LVEF,LVEDD)and CRT response than underweight patients(P<0.05).During the median follow-up time of 21 months,the overweight patients had higher survival rate in MACE and all-cause mortality compared with underweight patients(P<0.05).With adjusted risk factors,Multivariate Cox regression confirmed that BMI was a strong independent predictor of maj or adverse events(HR:0.88,95%CI:0.80-0.98,P=0.021)and all-cause mortality(HR:0.78,95%CI:0.65-0.95,P=0.015)in advanced HF patients after CRT implantation.Conclusions:Patients with overweight derived more benefit from CRT.Lower BMI in CRT patients was independently associated with worse clinical outcome in MACE and all-cause mortality.