PMID- 23643593
OWN - NLM
STAT- MEDLINE
DCOM- 20130927
LR  - 20130726
IS  - 1558-3597 (Electronic)
IS  - 0735-1097 (Linking)
VI  - 62
IP  - 5
DP  - 2013 Jul 30
TI  - Obesity and its association to phenotype and clinical course in hypertrophic 
      cardiomyopathy.
PG  - 449-57
LID - S0735-1097(13)01731-2 [pii]
LID - 10.1016/j.jacc.2013.03.062 [doi]
AB  - OBJECTIVES: This study sought to assess the impact of body mass index (BMI) on 
      cardiac phenotypic and clinical course in a multicenter hypertrophic 
      cardiomyopathy (HCM) cohort. BACKGROUND: It is unresolved whether clinical 
      variables promoting left ventricular (LV) hypertrophy in the general population, 
      such as obesity, may influence cardiac phenotypic and clinical course in patients 
      with HCM. METHODS: In 275 adult HCM patients (age 48 +/- 14 years; 70% male), we 
      assessed the relation of BMI to LV mass, determined by cardiovascular magnetic 
      resonance (CMR) and heart failure progression. RESULTS: At multivariate analysis, 
      BMI proved independently associated with the magnitude of hypertrophy: pre-obese 
      and obese HCM patients (BMI 25 to 30 kg/m(2) and >30 kg/m(2), respectively) 
      showed a 65% and 310% increased likelihood of an LV mass in the highest quartile 
      (>120 g/m(2)), compared with normal weight patients (BMI <25 kg/m(2); hazard 
      ratio [HR]: 1.65; 95% confidence interval [CI]: 0.73 to 3.74, p = 0.22 and 3.1; 
      95% CI: 1.42 to 6.86, p = 0.004, respectively). Other features associated with LV 
      mass >120 g/m(2) were LV outflow obstruction (HR: 4.9; 95% CI: 2.4 to 9.8; p < 
      0.001), systemic hypertension (HR: 2.2; 95% CI: 1.1 to 4.5; p = 0.026), and male 
      sex (HR: 2.1; 95% CI: 0.9 to 4.7; p = 0.083). During a median follow-up of 3.7 
      years (interquartile range: 2.5 to 5.3), obese patients showed an HR of 3.6 (95% 
      CI: 1.2 to 10.7, p = 0.02) for developing New York Heart Association (NYHA) 
      functional class III to IV symptoms compared to nonobese patients, independent of 
      outflow obstruction. Noticeably, the proportion of patients in NYHA functional 
      class III at the end of follow-up was 13% among obese patients, compared with 6% 
      among those of normal weight (p = 0.03). CONCLUSIONS: In HCM patients, extrinsic 
      factors such as obesity are independently associated with increase in LV mass and 
      may dictate progression of heart failure symptoms.
CI  - Copyright (c) 2013 American College of Cardiology Foundation. Published by Elsevier 
      Inc. All rights reserved.
FAU - Olivotto, Iacopo
AU  - Olivotto I
AD  - Referral Center for Myocardial Diseases, Azienda Ospedaliera Universitaria 
      Careggi, Florence, Italy. olivottoi@aou-careggi.toscana.it
FAU - Maron, Barry J
AU  - Maron BJ
FAU - Tomberli, Benedetta
AU  - Tomberli B
FAU - Appelbaum, Evan
AU  - Appelbaum E
FAU - Salton, Carol
AU  - Salton C
FAU - Haas, Tammy S
AU  - Haas TS
FAU - Gibson, C Michael
AU  - Gibson CM
FAU - Nistri, Stefano
AU  - Nistri S
FAU - Servettini, Eleonora
AU  - Servettini E
FAU - Chan, Raymond H
AU  - Chan RH
FAU - Udelson, James E
AU  - Udelson JE
FAU - Lesser, John R
AU  - Lesser JR
FAU - Cecchi, Franco
AU  - Cecchi F
FAU - Manning, Warren J
AU  - Manning WJ
FAU - Maron, Martin S
AU  - Maron MS
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20130430
PL  - United States
TA  - J Am Coll Cardiol
JT  - Journal of the American College of Cardiology
JID - 8301365
SB  - IM
CIN - J Am Coll Cardiol. 2013 Jul 30;62(5):458-9. PMID: 23643594
MH  - Adult
MH  - Body Mass Index
MH  - Cardiomyopathy, Hypertrophic/*epidemiology
MH  - Cohort Studies
MH  - Diabetes Mellitus, Type 2/epidemiology
MH  - Disease Progression
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Failure/classification/*epidemiology
MH  - Heart Ventricles/pathology
MH  - Humans
MH  - Hypertension/epidemiology
MH  - Italy/epidemiology
MH  - Likelihood Functions
MH  - Magnetic Resonance Imaging, Cine
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Obesity/*epidemiology
MH  - Phenotype
MH  - Sex Factors
MH  - United States/epidemiology
MH  - Ventricular Outflow Obstruction/epidemiology
OTO - NOTNLM
OT  - BMI
OT  - CMR
OT  - HCM
OT  - HR
OT  - LGE
OT  - LV
OT  - LVH
OT  - NYHA
OT  - New York Heart Association
OT  - body mass index
OT  - cardiac magnetic resonance
OT  - cardiovascular magnetic resonance
OT  - hazard ratio
OT  - hypertrophic cardiomyopathy
OT  - hypertrophy
OT  - late gadolinium enhancement
OT  - left ventricular
OT  - left ventricular hypertrophy
OT  - obesity
OT  - outcome
EDAT- 2013/05/07 06:00
MHDA- 2013/09/28 06:00
CRDT- 2013/05/07 06:00
PHST- 2012/10/03 00:00 [received]
PHST- 2013/03/03 00:00 [revised]
PHST- 2013/03/05 00:00 [accepted]
PHST- 2013/05/07 06:00 [entrez]
PHST- 2013/05/07 06:00 [pubmed]
PHST- 2013/09/28 06:00 [medline]
AID - S0735-1097(13)01731-2 [pii]
AID - 10.1016/j.jacc.2013.03.062 [doi]
PST - ppublish
SO  - J Am Coll Cardiol. 2013 Jul 30;62(5):449-57. doi: 10.1016/j.jacc.2013.03.062. 
      Epub 2013 Apr 30.