Impact of cardiorespiratory fitness on the obesity paradox in patients with systolic heart failure.

摘要: Although high body mass index (BMI) is associated with improved outcomes in established heart failure (HF), the impact of cardiorespiratory fitness on this obesity paradox less clear. We studied 1,675 patients systolic HF who underwent cardiopulmonary exercise testing at a single university center (77.4% men, mean age 52.2 ± 11.6 years, left ventricular ejection fraction 23.2 7.1% and New York Heart Association class III or IV 79.1%). evaluated 2-year survival stratified by both BMI (normal 18.5 to 24.9 kg/m 2 [reference], overweight 25 29.9 kg/m , obese ≥30.0 kg/m ) peak oxygen uptake (PKVO ; >14 ml/kg/minute, low ≤14 ml/kg/minute). At years, category was significantly for PKVO group (p (p = 0.1). In group, had decreased risk death free from urgent status 1A transplant assist device placement after multivariate adjustment compared normal (hazard ratio [HR] 0.64, 95% confidence interval [CI] 0.44 0.91, p = 0.01); no significant difference observed (HR CI 0.66 1.25, 0.5). In relation seen (overweight HR 0.75, 0.43 1.32, 0.3; 0.87, 1.75, 0.7). conclusion, only lower advanced cohort, indicating that functional capacity may attenuate paradox.