Kentaro Kamiya1, Takashi Masuda2, Yuya Matsue3, Takayuki Inomata4, Nobuaki Hamazaki5, Ryota Matsuzawa6, Shinya Tanaka7, Kohei Nozaki6, Emi Maekawa4, Chiharu Noda4, Minako Yamaoka-Tojo2, Atsuhiko Matsunaga2, Tohru Izumi4, Junya Ako4. 1. Department of Rehabilitation, Kitasato University Hospital, Sagamihara, Japan. Electronic address: k-kamiya@kitasato-u.ac.jp. 2. Department of Cardiovascular Medicine, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan; Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, Sagamihara, Japan. 3. Department of Cardiology, Kameda Medical Center, Chiba, Japan. 4. Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan. 5. Department of Rehabilitation, Kitasato University Hospital, Sagamihara, Japan; Department of Cardiovascular Medicine, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan. 6. Department of Rehabilitation, Kitasato University Hospital, Sagamihara, Japan. 7. Department of Cardiovascular Medicine, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan.
Abstract
OBJECTIVES: This study was performed to investigate the complementary role of arm circumference to body mass index (BMI) in risk stratification of patients with heart failure (HF). BACKGROUND: High BMI is associated with improved survival in patients with HF. However, it does not discriminate between fat and lean muscle as a predominant factor. METHODS: BMI, waist circumference (WC), and mid-upper arm circumference (MUAC) were evaluated in 570 consecutive Japanese patients with HF (mean age 67.4 ± 14.0 years). Patients were stratified into low and high groups according to BMI, WC, and MUAC and combined into low- or high-BMI and low- or high-WC groups or low- or high-BMI and low- or high-MUAC groups. The endpoint was all-cause mortality. RESULTS: Seventy deaths occurred over a median follow-up period of 1.5 years (interquartile range: 0.7 to 2.8 years). After adjusting for several pre-existing prognostic factors, including Seattle Heart Failure Score and exercise capacity, BMI (hazard ratio [HR]: 0.68; p = 0.016), WC (HR: 0.76; p = 0.044), and MUAC (HR: 0.52; p < 0.001) were all inversely associated with prognosis. Compared with the high-BMI/high-WC group, both the low-BMI/high-WC and low-BMI/low-WC groups showed comparably poorer prognosis. However, the low-BMI/low-MUAC group but not the low-BMI/high-MUAC group showed poorer prognosis than the high-BMI/high-MUAC group. Adding MUAC to BMI (0.70 vs. 0.63, p = 0.012) but not WC to BMI (0.64 vs. 0.63, p = 0.763) significantly increased the area under the curve on receiver-operating characteristic curve analysis. CONCLUSIONS: MUAC, but not WC, plays a complementary role to BMI in predicting prognosis in patients with HF.
OBJECTIVES: This study was performed to investigate the complementary role of arm circumference to body mass index (BMI) in risk stratification of patients with heart failure (HF). BACKGROUND: High BMI is associated with improved survival in patients with HF. However, it does not discriminate between fat and lean muscle as a predominant factor. METHODS: BMI, waist circumference (WC), and mid-upper arm circumference (MUAC) were evaluated in 570 consecutive Japanese patients with HF (mean age 67.4 ± 14.0 years). Patients were stratified into low and high groups according to BMI, WC, and MUAC and combined into low- or high-BMI and low- or high-WC groups or low- or high-BMI and low- or high-MUAC groups. The endpoint was all-cause mortality. RESULTS: Seventy deaths occurred over a median follow-up period of 1.5 years (interquartile range: 0.7 to 2.8 years). After adjusting for several pre-existing prognostic factors, including Seattle Heart Failure Score and exercise capacity, BMI (hazard ratio [HR]: 0.68; p = 0.016), WC (HR: 0.76; p = 0.044), and MUAC (HR: 0.52; p < 0.001) were all inversely associated with prognosis. Compared with the high-BMI/high-WC group, both the low-BMI/high-WC and low-BMI/low-WC groups showed comparably poorer prognosis. However, the low-BMI/low-MUAC group but not the low-BMI/high-MUAC group showed poorer prognosis than the high-BMI/high-MUAC group. Adding MUAC to BMI (0.70 vs. 0.63, p = 0.012) but not WC to BMI (0.64 vs. 0.63, p = 0.763) significantly increased the area under the curve on receiver-operating characteristic curve analysis. CONCLUSIONS:MUAC, but not WC, plays a complementary role to BMI in predicting prognosis in patients with HF.
Authors: Abhinav Sharma; Andrew P Ambrosy; Adam D DeVore; Kenneth B Margulies; Steven E McNulty; Robert J Mentz; Adrian F Hernandez; Gary Michael Felker; Lauren B Cooper; Anuradha Lala; Justin Vader; John D Groake; Barry A Borlaug; Eric J Velazquez Journal: ESC Heart Fail Date: 2018-08-17
Authors: Anupam Kumar; Bilal A Ansari; Jessica Kim; Arpita Suri; Sowmya Gaddam; Sowjanya Yenigalla; Jagan M Vanjarapu; Senthil Selvaraj; Dheera Tamvada; Jonathan Lee; Scott R Akers; Julio A Chirinos Journal: J Am Heart Assoc Date: 2019-02-19 Impact factor: 5.501
Authors: Stuart B Prenner; Raj Pillutla; Sowjanya Yenigalla; Sowmya Gaddam; Jonathan Lee; Mary Jo Obeid; Armghan Haider Ans; Qasim Jehangir; Jessica Kim; Payman Zamani; Jeremy A Mazurek; Scott R Akers; Julio A Chirinos Journal: J Am Heart Assoc Date: 2020-02-03 Impact factor: 5.501