Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
Circ J. 2010 Nov;74(12):2605-11. doi: 10.1253/circj.cj-10-0599. Epub 2010 Nov 2.
Obesity is a risk factor for cardiovascular disease (CVD) and is also associated with an increased risk of death in subjects without CVD. However, in heart failure (HF), elevated body mass index (BMI) has been shown to be associated with better prognosis, but it is unknown whether this is the case in unselected HF patients encountered in routine clinical practice in Japan.
The Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD) studied prospectively the characteristics and treatments in a broad sample of patients hospitalized with worsening HF and the outcomes were followed for 2.1 years. Study cohort (n=2,488) was classified into 3 groups according to baseline BMI: <20.3kg/m(2) (n=829), 20.3-23.49kg/m(2) (n=832), and ≥23.5kg/m(2) (n=827). The mean BMI was 22.3±4.1kg/m(2). Patients with higher BMI had lower rates of all-cause death, cardiac death, and rehospitalization because of worsening HF. After multivariable adjustment, the risk for all-cause death and cardiac death significantly increased with decreased BMI levels compared with patients with BMI ≥23.5kg/m(2). However, BMI levels were not associated with rehospitalization for worsening HF.
Lower BMI was independently associated with increased long-term all-cause, as well as cardiac, mortality in patients with HF encountered in routine clinical practice in Japan.
肥胖是心血管疾病（CVD）的一个危险因素，并且与无 CVD 的患者的死亡风险增加相关。然而，在心力衰竭（HF）中，升高的体重指数（BMI）已被证明与更好的预后相关，但在日本常规临床实践中遇到的未选择的 HF 患者中是否如此尚不清楚。
日本心脏病学心力衰竭注册研究（JCARE-CARD）前瞻性研究了广泛的因 HF 恶化而住院的患者的特征和治疗方法，并随访了 2.1 年。研究队列（n=2488）根据基线 BMI 分为 3 组：<20.3kg/m²（n=829），20.3-23.49kg/m²（n=832）和≥23.5kg/m²（n=827）。平均 BMI 为 22.3±4.1kg/m²。BMI 较高的患者全因死亡率、心脏死亡率和因 HF 恶化而再住院的发生率较低。经过多变量调整后，与 BMI≥23.5kg/m²的患者相比，BMI 水平降低与全因死亡和心脏死亡风险显著增加相关。然而，BMI 水平与因 HF 恶化而再住院无关。
在日本常规临床实践中遇到的 HF 患者中，较低的 BMI 与长期全因死亡以及心脏死亡的风险独立相关。
