Waist circumference, but not body mass index, is a predictor of ventricular remodeling after anterior myocardial infarction

Abstract Objective The impact of obesity on ventricular remodeling after myocardial infarction (MI) is still poorly understood. Therefore, the aim of this study was to evaluate the role of waist circumference (WC) and body mass index as predictors of cardiac remodeling in patients after an anterior...

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Published in:Nutrition (Burbank, Los Angeles County, Calif.) Los Angeles County, Calif.), 2013, Vol.29 (1), p.122-126
Main Authors: Cogni, Ana Lucia, M.D., Ph.D, Farah, Elaine, M.D., Ph.D, Minicucci, Marcos F., M.D., Ph.D, Azevedo, Paula S., M.D., Ph.D, Okoshi, Katashi, M.D., Ph.D, Matsubara, Beatriz B., M.D., Ph.D, Zanati, Silméia G., M.D., Ph.D, Paiva, Sergio A.R., M.D., Ph.D, Zornoff, Leonardo A.M., M.D., Ph.D
Format: Article
Language:English
Subjects:
Age
Aged
Angina pectoris
Biological and medical sciences
Body Mass Index
Cardiac arrhythmia
Cardiology. Vascular system
Cardiovascular disease
Confidence intervals
Coronary heart disease
Coronary occlusion
Echocardiography, Doppler, Color
Echocardiography, Doppler, Pulsed
Feeding. Feeding behavior
Female
Fundamental and applied biological sciences. Psychology
Gastroenterology and Hepatology
Gender
Heart
Heart attacks
Heart rate
Heart Ventricles - diagnostic imaging
Heart Ventricles - pathology
Humans
Hypertension
Ischemia
Male
Medical sciences
Metabolic diseases
Middle Aged
Myocardial Infarction - diagnostic imaging
Myocardial Infarction - pathology
Myocarditis. Cardiomyopathies
Obesity
Predictive Value of Tests
Prognosis
Prospective Studies
Studies
Ventricular dilatation
Ventricular Remodeling
Vertebrates: anatomy and physiology, studies on body, several organs or systems
Waist Circumference
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Summary:Abstract Objective The impact of obesity on ventricular remodeling after myocardial infarction (MI) is still poorly understood. Therefore, the aim of this study was to evaluate the role of waist circumference (WC) and body mass index as predictors of cardiac remodeling in patients after an anterior MI. Methods Eighty-three consecutive patients with anterior MI were prospectively evaluated. Clinical characteristics and echocardiographic data were analyzed at admission and at a 6-mo follow-up. Ventricular remodeling was defined as a 10% increase in left ventricular end-systolic or end-diastolic diameter at the 6-mo follow-up. Results In our study, 83 consecutive patients were evaluated (72% men). Ventricular remodeling was present in 31% of the patients (77% men). Patients with remodeling had higher creatine phosphokinase and creatine phosphokinase-MB peak values, a higher resting heart rate, a larger left atrial diameter, and a larger interventricular septum diastolic thickness. In addition, patients with remodeling had lower peak velocity of early ventricular filling deceleration time and ejection fraction. Patients with remodeling presented higher WC values (with remodeling, 99.2 ± 10.4 cm; without remodeling, 93.9 ± 10.8 cm, P = 0.04), but there were no differences in the body mass index values. In the logistic regression analysis, WC, adjusted by age, gender, ejection fraction, and creatine phosphokinase levels, was an independent predictor of left ventricular remodeling (odds ratio 1.067, 95% confidence interval 1.001–1.129, P = 0.02). Conclusion Waist circumference, but not body mass index, is a predictor of ventricular remodeling after an anterior MI. Therefore, the WC of these patients should be measured in clinical practice.
ISSN:0899-9007
1873-1244
DOI:10.1016/j.nut.2012.04.020