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Investigating the differences of body mass index and waist circumference in the follow-up assessment of patients to cardiac rehabilitation with acute coronary syndrome

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Abstract

Obesity management is a key point during cardiac rehabilitation. The effect of new index, waist circumference (WC), in the obesity management of cardiac rehabilitation is not clear yet. Therefore, our study compared the WC index to the body mass index (BMI) in the evaluation of obesity management for the patients with acute coronary syndrome (ACS) in a well-designed cardiac rehabilitation program (CRP). Totally 61 patients were enrolled into our study between October 2013 and January 2014 in our hospital. All these patients were requested to participate in the CRP actively for 6 months. We collected the BMI, WC, vital signs, fasting blood levels, the results from a sub-maximal exercise treadmill test (ETT) and ultrasonic cardiogram (UCG) through a follow-up visit conducted every 1, 3, and 6 months. We used two-tailed Pearson’s test and linear regression to analyze the data from our experiment. Our results show that the grouping of obese individuals based on the WC results in the WC being significantly associated with high-density lipoprotein cholesterol (HDL_C), inter-ventricular septal thickness at diastole (IVSd) and left ventricular posterior wall at diastole (LVPwd) after 1 and 3 months of the CRP (HDL_C after1 month of CRP: r = −0.292, P = 0.022; HDL_C after 3 months of CRP: r = −0.289, P = 0.024; IVSd after1 month of CRP: r = 0.451, P = 0.004; IVSd after 3 months of CRP: r = 0.304, P = 0.035; LVPwd after1 month of CRP: r = 0.468, P = 0.002; LVPwd after 3 months of CRP: r = 0.290, P = 0.045). However, no similar regular associations were found when obesity was stratified using the BMI. In other words, WC could be better than the BMI for reflecting the cardiac status. In conclusion, obesity management using WC can benefit the clinical evaluation, diagnosis, treatment, prevention, and prognosis of obese individuals of ACS when participating in the CRP.

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References

  1. Casado Cerrada J, Perez Calvo JI (2014) Organ damage and cardiorenal syndrome in acute heart failure. Med Clin (Barc) 142:26–31

    Article  Google Scholar 

  2. Bastien M, Poirier P, Lemieux I, Despres JP (2014) Overview of epidemiology and contribution of obesity to cardiovascular disease. Prog Cardiovasc Dis 56:369–381

    Article  PubMed  Google Scholar 

  3. Triest FJ, Singh SJ, Vanfleteren LE (2016) Cardiovascular risk, chronic obstructive pulmonary disease and pulmonary rehabilitation: Can we learn from cardiac rehabilitation? Chron Respir Dis. doi:10.1177/1479972316642367

    PubMed  Google Scholar 

  4. Goble AJ, Adey GM, Bullen JF (1963) Rehabilitation of the cardiac patient. Med J Aust 2:975–982

    CAS  PubMed  Google Scholar 

  5. Menezes AR, Lavie CJ, Milani RV, Forman DE, King M, Williams MA (2014) Cardiac rehabilitation in the United States. Prog Cardiovasc Dis 56:522–529

    Article  PubMed  Google Scholar 

  6. Reibis R, Voller H, Gitt A, Jannowitz C, Halle M, Pittrow D, Hildemann S (2014) Management of patients with ST-segment elevation or non-ST-segment elevation acute coronary syndromes in cardiac rehabilitation centers. Clin Cardiol 37:213–221

    Article  PubMed  Google Scholar 

  7. Pouche M, Ruidavets JB, Ferrieres J, Iliou MC, Douard H, Lorgis L, Carrie D, Brunel P, Simon T, Bataille V, Danchin N (2016) Cardiac rehabilitation and 5-year mortality after acute coronary syndromes: the 2005 French FAST-MI study. Arch Cardiovasc Dis 109:178–187

    Article  PubMed  Google Scholar 

  8. Audelin MC, Savage PD, Ades PA (2008) Changing clinical profile of patients entering cardiac rehabilitation/secondary prevention programs: 1996 to 2006. J Cardiopulm Rehabil Prev 28:299–306

    Article  PubMed  Google Scholar 

  9. de Koning L, Denhoff E, Kellogg MD, de Ferranti SD (2015) Associations of total and abdominal adiposity with risk marker patterns in children at high-risk for cardiovascular disease. BMC Obes 2:15

    Article  PubMed  PubMed Central  Google Scholar 

  10. Chase PJ, Davis PG, Bensimhon DR (2014) The obesity paradox in chronic heart failure: what does it mean? Curr Heart Fail Rep 11:111–117

    Article  CAS  PubMed  Google Scholar 

  11. Taylor J (2011) The obesity paradox. Eur Heart J 32:1575–1576

    CAS  PubMed  Google Scholar 

  12. De Schutter A, Lavie CJ, Milani RV (2014) The impact of obesity on risk factors and prevalence and prognosis of coronary heart disease-the obesity paradox. Prog Cardiovasc Dis 56:401–408

    Article  PubMed  Google Scholar 

  13. Gruberg L, Weissman NJ, Waksman R, Fuchs S, Deible R, Pinnow EE, Ahmed LM, Kent KM, Pichard AD, Suddath WO et al (2002) The impact of obesity on the short-term and long-term outcomes after percutaneous coronary intervention: the obesity paradox? J Am Coll Cardiol 39:578–584

    Article  PubMed  Google Scholar 

  14. Feng RN, Zhao C, Wang C, Niu YC, Li K, Guo FC, Li ST, Sun CH, Li Y (2012) BMI is strongly associated with hypertension, and waist circumference is strongly associated with type 2 diabetes and dyslipidemia, in northern Chinese adults. Journal Of Epidemiology 22:317–323

    Article  PubMed  PubMed Central  Google Scholar 

  15. Flores-Huerta S, Klunder-Klunder M, de la Cruz LR, Santos JI (2009) Increase in body mass index and waist circumference is associated with high blood pressure in children and adolescents in Mexico City. Arch Med Res 40:208–215

    Article  PubMed  Google Scholar 

  16. Dong X, Liu Y, Yang J, Sun Y, Chen L (2011) Efficiency of anthropometric indicators of obesity for identifying cardiovascular risk factors in a Chinese population. Postgrad Med J 87:251–256

    Article  PubMed  Google Scholar 

  17. Blackford K, Jancey J, Lee AH, James AP, Waddell T, Howat P (2016) Home-based lifestyle intervention for rural adults improves metabolic syndrome parameters and cardiovascular risk factors: a randomised controlled trial. Prev Med 89:15–22

    Article  PubMed  Google Scholar 

  18. Lam BC, Koh GC, Chen C, Wong MT, Fallows SJ (2015) Comparison of Body Mass Index (BMI), Body Adiposity Index (BAI), Waist Circumference (WC), Waist-To-Hip Ratio (WHR) and Waist-To-Height Ratio (WHtR) as predictors of cardiovascular disease risk factors in an adult population in Singapore. PLoS ONE 10:e0122985

    Article  PubMed  PubMed Central  Google Scholar 

  19. George C, Goedecke JH, Crowther NJ, Jaff NG, Kengne AP, Norris SA, Micklesfield LK (2016) The Role of Body Fat and Fat Distribution in Hypertension Risk in Urban Black South African Women. PLoS ONE 11:e0154894

    Article  PubMed  PubMed Central  Google Scholar 

  20. El Mabchour A, Delisle H, Vilgrain C, Larco P, Sodjinou R, Batal M (2015) Specific cut-off points for waist circumference and waist-to-height ratio as predictors of cardiometabolic risk in Black subjects: a cross-sectional study in Benin and Haiti. Diabetes Metab Syndr Obes 8:513–523

    Article  PubMed  Google Scholar 

  21. Batsis JA, Zbehlik AJ, Barre LK, Mackenzie TA, Bartels SJ (2014) The impact of waist circumference on function and physical activity in older adults: longitudinal observational data from the osteoarthritis initiative. Nutr J 13:81

    Article  PubMed  PubMed Central  Google Scholar 

  22. Pattyn N, Cornelissen VA, Eshghi SR, Vanhees L (2013) The effect of exercise on the cardiovascular risk factors constituting the metabolic syndrome: a meta-analysis of controlled trials. Sports Med 43:121–133

    Article  PubMed  Google Scholar 

  23. Swift DL, Lavie CJ, Johannsen NM, Arena R, Earnest CP, O’Keefe JH, Milani RV, Blair SN, Church TS (2013) Physical activity, cardiorespiratory fitness, and exercise training in primary and secondary coronary prevention. Circ J 77:281–292

    Article  PubMed  Google Scholar 

  24. Zullo MD, Jackson LW, Whalen CC, Dolansky MA (2012) Evaluation of the recommended core components of cardiac rehabilitation practice: an opportunity for quality improvement. J Cardiopulm Rehabil Prev 32:32–40

    Article  PubMed  Google Scholar 

  25. Zafrir B, Khashper A, Gaspar T, Dobrecky-Mery I, Azencot M, Lewis BS, Rubinshtein R, Halon DA (2015) Prognostic impact of abdominal fat distribution and cardiorespiratory fitness in asymptomatic type 2 diabetics. Eur J Prev Cardiol 22:1146–1153

    Article  PubMed  Google Scholar 

  26. Nalini M, Moradi B, Esmaeilzadeh M, Maleki M (2013) Does the effect of supervised cardiac rehabilitation programs on body fat distribution remained long time? J Cardiovasc Thorac Res 5:133–138

    PubMed  PubMed Central  Google Scholar 

  27. Ades PA, Savage PD, Harvey-Berino J (2010) The treatment of obesity in cardiac rehabilitation. J Cardiopulm Rehabil Prev 30:289–298

    Article  PubMed  PubMed Central  Google Scholar 

  28. Chen C, Lu FC (2004) Department of Disease Control Ministry of Health PRC: the guidelines for prevention and control of overweight and obesity in Chinese adults. Biomed Environ Sci 17(Suppl):1–36

    PubMed  Google Scholar 

  29. Lopatynski J, Mardarowicz G, Szczesniak G (2003) A comparative evaluation of waist circumference, waist-to-hip ratio, waist-to-height ratio and body mass index as indicators of impaired glucose tolerance and as risk factors for type-2 diabetes mellitus. Ann Univ Mariae Curie Sklodowska Med 58:413–419

    PubMed  Google Scholar 

  30. Zhai Y, Zhao WH, Chen CM (2010) Verification on the cut-offs of waist circumference for defining central obesity in Chinese elderly and tall adults. Zhonghua Liu Xing Bing Xue Za Zhi 31:621–625

    PubMed  Google Scholar 

  31. Ades PA, Savage PD (2014) Potential benefits of weight loss in coronary heart disease. Prog Cardiovasc Dis 56:448–456

    Article  PubMed  Google Scholar 

  32. Lu B, Yang Y, Song X, Dong X, Zhang Z, Zhou L, Li Y, Zhao N, Zhu X, Hu R (2006) An evaluation of the International Diabetes Federation definition of metabolic syndrome in Chinese patients older than 30 years and diagnosed with type 2 diabetes mellitus. Metabolism 55:1088–1096

    Article  CAS  PubMed  Google Scholar 

  33. Ruan Y, Mo M, Joss-Moore L, Li YY, Yang QD, Shi L, Zhang H, Li R, Xu WH (2013) Increased waist circumference and prevalence of type 2 diabetes and hypertension in Chinese adults: two population-based cross-sectional surveys in Shanghai. China. BMJ Open 3:e003408

    Article  PubMed  Google Scholar 

  34. Feng RN, Zhao C, Wang C, Niu YC, Li K, Guo FC, Li ST, Sun CH, Li Y (2012) BMI is strongly associated with hypertension, and waist circumference is strongly associated with type 2 diabetes and dyslipidemia, in northern Chinese adults. J Epidemiol 22:317–323

    Article  PubMed  PubMed Central  Google Scholar 

  35. Jacobs EJ, Newton CC, Wang Y, Patel AV, McCullough ML, Campbell PT, Thun MJ, Gapstur SM (2010) Waist circumference and all-cause mortality in a large US cohort. Arch Intern Med 170:1293–1301

    Article  PubMed  Google Scholar 

  36. InterAct C, Langenberg C, Sharp SJ, Schulze MB, Rolandsson O, Overvad K, Forouhi NG, Spranger J, Drogan D, Huerta JM et al (2012) Long-term risk of incident type 2 diabetes and measures of overall and regional obesity: the EPIC-InterAct case-cohort study. PLoS Med 9:e1001230

    Article  Google Scholar 

  37. Li R, Shi L, Jia J, Li Y, Yang Q, Ruan Y, Chen R, Kan H (2015) Differentiating the associations of waist circumference and body mass index with cardiovascular disease risk in a chinese population. Asia Pac J Public Health. doi:10.1177/1010539512465306

    Google Scholar 

  38. Consultation WHOE (2004) Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet 363:157–163

    Article  Google Scholar 

  39. Oda E, Kawai R (2010) Body mass index is more strongly associated with hypertension than waist circumference in apparently healthy Japanese men and women. Acta Diabetol 47:309–313

    Article  PubMed  Google Scholar 

  40. Zeng Q, He Y, Dong S, Zhao X, Chen Z, Song Z, Chang G, Yang F, Wang Y (2014) Optimal cut-off values of BMI, waist circumference and waist: height ratio for defining obesity in Chinese adults. Br J Nutr 112:1735–1744

    Article  CAS  PubMed  Google Scholar 

  41. Krumholz HM, Larson M, Levy D (1995) Prognosis Of left-ventricular geometric patterns in the Framingham Heart-Study. J Am Coll Cardiol 25:879–884

    Article  CAS  PubMed  Google Scholar 

  42. Patel DA, Lavie CJ, Milani RV, Gilliland Y, Shah S, Ventura HO (2011) Association of Left Ventricular Geometry With Left Atrial Enlargement in Patients With Preserved Ejection Fraction. Congest Heart Fail

  43. Henry SL, Barzel B, Wood-Bradley RJ, Burke SL, Head GA, Armitage JA (2012) Developmental origins of obesity-related hypertension. Clin Exp Pharmacol Physiol 39:799–806

    Article  CAS  PubMed  Google Scholar 

  44. Klop B, Elte JWF, Cabezas MC (2013) Dyslipidemia in obesity: mechanisms and potential targets. Nutrients 5:1218–1240

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  45. Lavie CJ, McAuley PA, Church TS, Milani RV, Blair SN (2014) Obesity and cardiovascular diseases. J Am Coll Cardiol 63:1345–1354

    Article  PubMed  Google Scholar 

  46. Lavie CJ, Cahalin LP, Chase P, Myers J, Bensimhon D, Peberdy MA, Ashley E, West E, Forman DE, Guazzi M, Arena R (2013) Impact of cardiorespiratory fitness on the obesity paradox in patients with heart failure. Mayo Clin Proc 88:251–258

    Article  PubMed  Google Scholar 

  47. Turkbey EB, McClelland RL, Kronmal RA, Burke GL, Bild DE, Tracy RP, Arai AE, Lima JA, Bluemke DA (2010) The impact of obesity on the left ventricle: the Multi-Ethnic Study of Atherosclerosis (MESA). JACC Cardiovasc Imaging 3:266–274

    Article  PubMed  PubMed Central  Google Scholar 

  48. Apridonidze T, Shaqra H, Ktaich N, Liu JE, Bella JN (2011) Relation of components of the metabolic syndrome to left ventricular geometry in hispanic and non-hispanic black adults. Am J Cardiovasc Dis 1:84–91

    CAS  PubMed  PubMed Central  Google Scholar 

  49. Reis JP, Allen N, Gibbs BB, Gidding SS, Lee JM, Lewis CE, Lima J, Lloyd-Jones D, Loria CM, Powell-Wiley TM et al (2014) Association of the degree of adiposity and duration of obesity with measures of cardiac structure and function: the CARDIA study. Obesity (Silver Spring) 22:2434–2440

    Article  Google Scholar 

  50. Bennasar-Veny M, Lopez-Gonzalez AA, Tauler P, Cespedes ML, Vicente-Herrero T, Yanez A, Tomas-Salva M, Aguilo A (2013) Body adiposity index and cardiovascular health risk factors in Caucasians: a comparison with the body mass index and others. PLoS ONE 8:e63999

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  51. Romero-Corral A, Somers VK, Sierra-Johnson J, Jensen MD, Thomas RJ, Squires RW, Allison TG, Korinek J, Lopez-Jimenez F (2007) Diagnostic performance of body mass index to detect obesity in patients with coronary artery disease. Eur Heart J 28:2087–2093

    Article  PubMed  Google Scholar 

  52. Canepa M, Strait JB, Abramov D, Milaneschi Y, AlGhatrif M, Moni M, Ramachandran R, Najjar SS, Brunelli C, Abraham TP et al (2012) Contribution of central adiposity to left ventricular diastolic function (from the Baltimore Longitudinal Study of Aging). Am J Cardiol 109:1171–1178

    Article  PubMed  PubMed Central  Google Scholar 

  53. Bombelli M, Facchetti R, Sega R, Carugo S, Fodri D, Brambilla G, Giannattasio C, Grassi G, Mancia G (2011) Impact of body mass index and waist circumference on the long-term risk of diabetes mellitus, hypertension, and cardiac organ damage. Hypertension 58:1029–1035

    Article  CAS  PubMed  Google Scholar 

  54. Cogni AL, Farah E, Minicucci MF, Azevedo PS, Okoshi K, Matsubara BB, Zanati SG, Paiva SA, Zornoff LA (2013) Waist circumference, but not body mass index, is a predictor of ventricular remodeling after anterior myocardial infarction. Nutrition 29:122–126

    Article  PubMed  Google Scholar 

  55. Hall JE (2000) Pathophysiology of obesity hypertension. Curr Hypertens Rep 2:139–147

    Article  CAS  PubMed  Google Scholar 

  56. Lavie P, Yoffe N, Berger I, Peled R (1993) The relationship between the severity of sleep apnea syndrome and 24-h blood pressure values in patients with obstructive sleep apnea. Chest 103:717–721

    Article  CAS  PubMed  Google Scholar 

  57. Buhler C, Schaub AF, Vetter W (1994) Importance of sleep apnea syndromes in the assessment of hypertension. Praxis (Bern 1994), 83: 1250–1253

  58. Kotsis V, Stabouli S, Papakatsika S, Rizos Z, Parati G (2010) Mechanisms of obesity-induced hypertension. Hypertens Res 33:386–393

    Article  PubMed  Google Scholar 

  59. Schlaich MP, Esler MD (2003) Sympathetic nerve activity in essential hypertension. New pathophysiologic aspects. Dtsch Med Wochenschr 128:677–681

    Article  CAS  PubMed  Google Scholar 

  60. Willard PW, Fuller RW (1969) Functional significance of the sympathetic nervous system in production of hypertension. Nature 223:417–418

    Article  CAS  PubMed  Google Scholar 

  61. Heymsfield SB, Peterson CM, Thomas DM, Heo M, Schuna JM Jr, Hong S, Choi W (2014) Scaling of adult body weight to height across sex and race/ethnic groups: relevance to BMI. Am J Clin Nutr 100:1455–1461

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  62. He J, Guo S, Liu J, Zhang M, Ding Y, Zhang J, Li S, Xu S, Niu Q, Guo H, Ma R (2014) Ethnic differences in prevalence of general obesity and abdominal obesity among low-income rural Kazakh and Uyghur adults in far western China and implications in preventive public health. PLoS ONE 9:e106723

    Article  PubMed  PubMed Central  Google Scholar 

  63. Takahara M, Katakami N, Kaneto H, Noguchi M, Shimomura I (2012) Statistical reassessment of the association between waist circumference and clustering metabolic abnormalities in Japanese population. J Atheroscler Thromb 19:767–778

    PubMed  Google Scholar 

  64. Davis J, Juarez D, Hodges K (2013) Relationship of ethnicity and body mass index with the development of hypertension and hyperlipidemia. Ethn Dis 23:65–70

    PubMed  PubMed Central  Google Scholar 

  65. Oda E, Kawai R (2010) Body mass index is more strongly associated with hypertension than waist circumference in apparently healthy Japanese men and women. Acta Diabetol 47:309–313

    Article  PubMed  Google Scholar 

  66. Sarno F, Monteiro CA (2007) Relative importance of body mass index and waist circumference for hypertension in adults. Rev Saude Publica 41:788–796

    Article  PubMed  Google Scholar 

  67. Warren TY, Wilcox S, Dowda M, Baruth M (2012) Independent association of waist circumference with hypertension and diabetes in African American women, South Carolina, 2007-2009. Prev Chronic Dis 9:E105

    PubMed  PubMed Central  Google Scholar 

  68. Hou X, Lu J, Weng J, Ji L, Shan Z, Liu J, Tian H, Ji Q, Zhu D, Ge J et al (2013) Impact of waist circumference and body mass index on risk of cardiometabolic disorder and cardiovascular disease in Chinese adults: a national diabetes and metabolic disorders survey. PLoS ONE 8:e57319

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  69. Blumenthal JA, Babyak MA, Hinderliter A, Watkins LL, Craighead L, Lin PH, Caccia C, Johnson J, Waugh R, Sherwood A (2010) Effects of the DASH diet alone and in combination with exercise and weight loss on blood pressure and cardiovascular biomarkers in men and women with high blood pressure the ENCORE study. Arch Intern Med 170:126–135

    Article  PubMed  PubMed Central  Google Scholar 

  70. Collins CL, Suskin N, Aggarwal S, Grace SL, (2014) Cardiac rehabilitation wait times and relation to patient outcomes. Eur J Phys Rehabil Med

  71. Stoller O, de Bruin ED, Schuster-Amft C, Schindelholz M, de Bie RA, Hunt KJ (2013) Cardiovascular rehabilitation soon after stroke using feedback-controlled robotics-assisted treadmill exercise: study protocol of a randomised controlled pilot trial. Trials 14:304

    Article  PubMed  PubMed Central  Google Scholar 

  72. Smialek J, Lelakowski J, Majewski J (2013) Efficacy and safety of early comprehensive cardiac rehabilitation following the implantation of cardioverter-defibrillator. Kardiol Pol 71:1021–1028

    Article  PubMed  Google Scholar 

  73. Koifman E, Grossman E, Elis A, Dicker D, Koifman B, Mosseri M, Kuperstein R, Goldenberg I, Kamerman T, Levine-Tiefenbrun N, Klempfner R (2014) Multidisciplinary rehabilitation program in recently hospitalized patients with heart failure and preserved ejection fraction: rationale and design of a randomized controlled trial. Am Heart J 168(830–837):e831

    Google Scholar 

  74. Temcharoen P, Kaewboonruang P, Pradipasen M, Srisorachart S (2009) The optimal cut-off points of body mass index which reflect the risk factors of cardiovascular disease in the urban Thai male population. J Med Assoc Thai 92(Suppl 7):S68–S74

    PubMed  Google Scholar 

  75. Nube M (2009) The Asian enigma: predisposition for low adult BMI among people of South Asian descent. Public Health Nutr 12:507–516

    Article  PubMed  Google Scholar 

  76. Cheong KC, Yusoff AF, Ghazali SM, Lim KH, Selvarajah S, Haniff J, Khor GL, Shahar S, Rahman JA, Zainuddin AA, Mustafa AN (2013) Optimal BMI cut-off values for predicting diabetes, hypertension and hypercholesterolaemia in a multi-ethnic population. Public Health Nutr 16:453–459

    Article  PubMed  Google Scholar 

  77. Dagenais GR, Yi QL, Mann JFE, Bosch J, Pogue J, Yusuf S, Evaluati HOP (2005) Prognostic impact of body weight and abdominal obesity in women and men with cardiovascular disease. Am Heart J 149:54–60

    Article  PubMed  Google Scholar 

  78. Kragelund C, Hassager C, Hildebrandt P, Torp-Pedersen C, Kober L, Grp TS (2005) Impact of obesity on long-term prognosis following acute myocardial infarction. Int J Cardiol 98:123–131

    Article  PubMed  Google Scholar 

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Acknowledgments

Our work was supported partly by the Science and Technology Planning Project of Guangdong Province (2013A022100036, 2014A020212257).

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Correspondence to Lin Xu or Jian Qiu.

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Hui Zhao and Jun Ma have contributed equally to this work.

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Zhao, H., Ma, J., Zhou, Q. et al. Investigating the differences of body mass index and waist circumference in the follow-up assessment of patients to cardiac rehabilitation with acute coronary syndrome. Australas Phys Eng Sci Med 39, 1007–1027 (2016). https://doi.org/10.1007/s13246-016-0471-9

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