PMID- 23529754
OWN - NLM
STAT- MEDLINE
DCOM- 20140219
LR  - 20211021
IS  - 1569-9285 (Electronic)
IS  - 1569-9293 (Print)
IS  - 1569-9285 (Linking)
VI  - 17
IP  - 1
DP  - 2013 Jul
TI  - Impact of obesity on long-term survival after aortic valve replacement with a 
      small prosthesis.
PG  - 66-72
LID - 10.1093/icvts/ivt058 [doi]
AB  - OBJECTIVES: Although many studies have evaluated the impact of obesity on various 
      medical treatments, it is not known whether obesity is related to late mortality 
      with implantation of small aortic prostheses. This study evaluated the effect of 
      obesity on the late survival of patients after aortic valve replacement (AVR) 
      with implantation of a small aortic prosthesis (size </= 21 mm). METHODS: From 
      January 1998 to December 2008, 307 patients in our institution who underwent 
      primary AVR with smaller prostheses survived 30 days after surgery. Patients were 
      categorized as normal weight if body mass index (BMI) was <24 kg/m(2), overweight 
      if BMI 24-27.9 kg/m(2) and obese if BMI >/= 28 kg/m(2). Data of the New York Heart 
      Association (NYHA) functional classification, left ventricular ejection fraction 
      (LVEF), effective orifice area index (EOAI) and left ventricular mass index of 
      the patients were collected at the third month, sixth month, first year, third 
      year, fifth year and eighth year after operation. RESULTS: By multivariable 
      analysis, obesity was a significant independent factor of late mortality (hazard 
      ratio: 1.62; P = 0.01). The obese and overweight groups of patients exhibited 
      lower survival (P < 0.001) and a higher proportion in NYHA Class III/IV (P < 
      0.01) compared with the normal group. A lower EOAI and higher left ventricular 
      mass index were found in the obese and overweight groups, but we saw no 
      significant variance in LVEF among the three groups. CONCLUSIONS: Obesity is 
      associated with increased late mortality of patients after AVR with implantation 
      of small aortic prosthesis. Obesity or/and overweight may also affect the NYHA 
      classification, even in the longer term. EOAI should be improved where possible, 
      as it may reduce late mortality and improve quality of life in obese or 
      overweight patients.
FAU - Wang, Biao
AU  - Wang B
AD  - Department of Cardiovascular Surgery, Qilu Hospital, Shandong University, Jinan, 
      China.
FAU - Yang, Hongyang
AU  - Yang H
FAU - Wang, Tao
AU  - Wang T
FAU - Zhang, Xiquan
AU  - Zhang X
FAU - Zhu, Wenjie
AU  - Zhu W
FAU - Cao, Guangqing
AU  - Cao G
FAU - Wu, Shuming
AU  - Wu S
LA  - eng
PT  - Journal Article
DEP - 20130325
PL  - England
TA  - Interact Cardiovasc Thorac Surg
JT  - Interactive cardiovascular and thoracic surgery
JID - 101158399
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aortic Valve/*surgery
MH  - *Bioprosthesis
MH  - Body Mass Index
MH  - Chi-Square Distribution
MH  - Female
MH  - Heart Valve Diseases/complications/mortality/*surgery
MH  - *Heart Valve Prosthesis
MH  - Heart Valve Prosthesis Implantation/adverse effects/*instrumentation
MH  - Humans
MH  - Kaplan-Meier Estimate
MH  - Logistic Models
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Obesity/*complications/diagnosis/mortality
MH  - Proportional Hazards Models
MH  - Prosthesis Design
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Time Factors
MH  - Treatment Outcome
PMC - PMC3686364
OTO - NOTNLM
OT  - Aortic valve replacement
OT  - Body mass index
OT  - Obesity
OT  - Small aortic root
EDAT- 2013/03/27 06:00
MHDA- 2014/02/20 06:00
PMCR- 2014/07/01
CRDT- 2013/03/27 06:00
PHST- 2013/03/27 06:00 [entrez]
PHST- 2013/03/27 06:00 [pubmed]
PHST- 2014/02/20 06:00 [medline]
PHST- 2014/07/01 00:00 [pmc-release]
AID - ivt058 [pii]
AID - 10.1093/icvts/ivt058 [doi]
PST - ppublish
SO  - Interact Cardiovasc Thorac Surg. 2013 Jul;17(1):66-72. doi: 10.1093/icvts/ivt058. 
      Epub 2013 Mar 25.