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Impact of cardiac resynchronization therapy-defibrillator implantation on the association between body mass index and prognosis in patients with heart failure

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Abstract

Purpose

This study aimed to examine the association between body mass index (BMI) and prognosis in heart failure patients after cardiac resynchronization therapy-defibrillator (CRT-D) implantation.

Methods

We retrospectively investigated 125 patients (33 overweight [BMI ≥25 kg/m2], 75 normal weight [BMI 18.5–24.9 kg/m2], and 17 underweight patients [BMI <18.5 kg/m2]) who underwent CRT-D implantation. The clinical outcome endpoints were all-cause death and appropriate shock therapy.

Results

During the follow-up period (mean 3.1 ± 1.8 years), 23 patients died (1 [3.0 %] overweight, 17 [22.7 %] normal weight, and 5 [29.4 %] underweight patients), and appropriate shock events were observed in 14 patients (2 [6.1 %] overweight, 10 [13.3 %] normal weight, and 2 [11.8 %] underweight patients). All patients survived shock therapy. After adjusting for confounding factors, overweight patients had significantly fewer outcomes relating to all-cause death and appropriate shock events (hazard ratio 0.27, 95 % confidence interval 0.08–0.91, p = 0.034) than normal weight patients. However, the prognostic difference between overweight and normal weight patients could be diminished as a result of the successful shock therapies (p = 0.067). Additionally, prognosis did not differ between overweight and normal weight patients among the responders, but did differ among the non-responders. The underweight patients had a poorer prognosis after CRT-D implantation compared with the other groups.

Conclusions

Although high BMI was associated with better outcomes among heart failure patients with CRT-D implantations, the difference in the prognosis between overweight and normal weight patients was reduced because of defibrillator therapy and the improvement in cardiac function provided by CRT-D implantation.

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Conflict of interest

The authors declare that they have no competing interests.

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Authors and Affiliations

  1. Department of Cardiology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan

    Satoshi Yanagisawa, Yasuya Inden, Masayuki Shimano, Naoki Yoshida, Shinji Ishikawa, Hiroyuki Kato, Satoshi Okumura, Aya Miyoshi-Fujii, Tomoyuki Nagao, Toshihiko Yamamoto, Yoshiaki Mizutani, Tadahiro Ito & Toyoaki Murohara

  2. Department of Cardiology, Chunichi Hospital, Nagoya, Aichi, Japan

    Satoshi Yanagisawa

  3. Department of Cardiology, Nagoya University Graduate School of Health Science, Nagoya, Japan

    Makoto Hirai

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  1. Satoshi Yanagisawa
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  2. Yasuya Inden
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  3. Masayuki Shimano
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Correspondence to Yasuya Inden.

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Yanagisawa, S., Inden, Y., Shimano, M. et al. Impact of cardiac resynchronization therapy-defibrillator implantation on the association between body mass index and prognosis in patients with heart failure. J Interv Card Electrophysiol 43, 269–277 (2015). https://doi.org/10.1007/s10840-015-0015-3

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  • DOI: https://doi.org/10.1007/s10840-015-0015-3

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