Holt Margrethe Flesvig, Holmen Stine, Rolid Katrine, Englund Kristine V Brautaset, Østby Charlotte M, Ravnestad Håvard, Andreassen Arne K, Gullestad Lars, Gude Einar, Broch Kaspar
Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
Front Transplant. 2024 May 15;3:1379695. doi: 10.3389/frtra.2024.1379695. eCollection 2024.
Pre-transplant obesity and weight gain after heart transplantation are both associated with increased risk of poor clinical outcomes. We aimed to assess the association between overweight or obesity, exercise capacity, and health-related quality of life in heart transplant recipients.
This study is based on baseline data from the IronIC trial, in which we randomized 102 heart transplant recipients with iron deficiency to ferric derisomaltose or placebo. We performed cardio pulmonary exercise testing in all participants. To assess quality of life, we used the SF-36v2 questionnaire, using two sum scores: the physical component summary and the mental component summary. A minimal clinically important difference was defined as ≥2 and ≥3 for the physical and the mental component summary, respectively.
24/102 heart transplant recipients (24%) had a body mass index (BMI) ≥30 kg/m. Peak oxygen consumption was 17.3 ± 4.6 ml/kg/min in the obese group vs. 24.7 ± 6.4 ml/kg/min in the group with a BMI <30 for a between-group difference of 7.4 (95% confidence interval 4.7-10.2) ml/kg/min: < 0.001. The physical component summary score was on average 5.2 points lower in the patients with a body mass index ≥30 than in the lower weight group ( = 0.04).
Almost a quarter of our heart transplant recipients in long-term follow-up had a BMI ≥30 kg/m. These patients had substantially lower exercise capacity and lower quality of life in the physical domain.
心脏移植前肥胖和心脏移植后体重增加均与不良临床结局风险增加相关。我们旨在评估心脏移植受者超重或肥胖、运动能力和健康相关生活质量之间的关联。
本研究基于IronIC试验的基线数据，在该试验中，我们将102名缺铁的心脏移植受者随机分为去铁胺麦芽糖铁组或安慰剂组。我们对所有参与者进行了心肺运动测试。为了评估生活质量，我们使用了SF-36v2问卷，采用两个总分：身体成分总结分和心理成分总结分。身体和心理成分总结分的最小临床重要差异分别定义为≥2分和≥3分。
102名心脏移植受者中有24名（24%）体重指数（BMI）≥30kg/m²。肥胖组的峰值耗氧量为17.3±4.6ml/kg/min，而BMI<30的组为24.7±6.4ml/kg/min，组间差异为7.4（95%置信区间4.7-10.2）ml/kg/min，P<0.001。体重指数≥30的患者的身体成分总结分平均比体重较轻组低5.2分（P=0.04）。
在我们长期随访的心脏移植受者中，近四分之一的人体重指数≥30kg/m²。这些患者的运动能力明显较低，身体领域的生活质量也较低。
