Effect of obesity on outcomes in patients undergoing implantation of continuous-flow left ventricular assist devices

  • Nastasya Volkovicher
  • Chitaru Kurihara
  • Andre Critsinelis
  • Masashi Kawabori
  • Tadahisa Sugiura
  • Marcos ManonII
  • Andrew B. Civitello
  • Jeffrey A. Morgan
Original Article Artificial Heart (Clinical)

Abstract

The purpose of this study was to analyze the effect of obesity on outcomes after continuous-flow left ventricular assist device (CF-LVAD) implantation. A single-center retrospective analysis was performed on 526 chronic heart failure patients who were implanted with the HeartMate II CF-LVAD (n = 403) or HeartWare HVAD (n = 123) between November 2003 and March 2016. Patients were stratified into 4 groups based on BMI: underweight (< 18.5 kg/m2, n = 18, 3.4%), normal-weight (18.5–25 kg/m2, n = 173, 32.9%), overweight (25–30 kg/m2, n = 182, 30.2%), and obese (> 30 kg/m2, n = 153, 33.5%). The underweight group was excluded because of its small sample size. Records were reviewed to determine the incidence of postoperative complications and survival. Survival at 1, 6, 12, and 24 months were similar among normal-weight (91.3, 84.4, 76.3, and 67.6%), overweight (90.4, 80.8, 76.5, and 69.6%), and obese patients (90.7, 74.7, 65.3, and 61.3%, p = 0.24). Additionally, obesity was not a significant predictor of mortality in Cox proportional hazard models (hazard ratio 0.98, 95% confidence interval 0.766–1.277, p = 0.13). These findings suggest that appropriately selected obese patients receive similar survival benefit from CF-LVADs compared to non-obese patients, and obesity should not serve as a contraindication to CF-LVAD implantation.

Keywords

Left ventricular assist device (LVAD) Body mass index (BMI) Obesity Heart failure 

Notes

Acknowledgements

The authors thank Drs. MacArthur A. Elayda and Suwei Wang of the Department of Biostatistics and Epidemiology at the Texas Heart Institute for their timely help in analyzing our large dataset. The Section of Scientific Publications at the Texas Heart Institute provided editorial support.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© The Japanese Society for Artificial Organs 2017

Authors and Affiliations

  • Nastasya Volkovicher
    • 1
    • 2
  • Chitaru Kurihara
    • 1
    • 2
    • 3
  • Andre Critsinelis
    • 1
    • 2
  • Masashi Kawabori
    • 1
    • 2
  • Tadahisa Sugiura
    • 1
    • 2
  • Marcos ManonII
    • 1
    • 2
  • Andrew B. Civitello
    • 1
    • 2
  • Jeffrey A. Morgan
    • 1
    • 2
  1. 1.Division of Cardiothoracic Transplant and Assist DevicesBaylor College of MedicineHoustonUSA
  2. 2.Department of Cardiopulmonary Transplantation and the Center for Cardiac SupportTexas Heart InstituteHoustonUSA
  3. 3.Department of Cardiothoracic SurgeryTokyo Metropolitan Geriatric Hospital and Institute of GerontologyTokyoJapan

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