Obesity in heart failure with preserved ejection fraction: Insights from the REDUCE LAP‐HF II trial
Article Swipe
Sheldon E. Litwin
,
Jan Komtebedde
,
Tim Seidler
,
Barry A. Borlaug
,
Sebastian Winkler
,
Scott D. Solomon
,
Jean‐Christophe Eicher
,
Sula Mazimba
,
Rami Khawash
,
Aaron L. Sverdlov
,
Scott L. Hummel
,
Heiko Bugger
,
Florian Boenner
,
Elke S. Hoendermis
,
Maja Čikeš
,
Catherine Demers
,
Guillherme Silva
,
Vanessa van Empel
,
Randall C. Starling
,
Martin Pěnička
,
Donald E. Cutlip
,
Martin B. Leon
,
Dalane W. Kitzman
,
Dirk J. van Veldhuisen
,
Sanjiv J. Shah
·
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.1002/ejhf.3092
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.1002/ejhf.3092
Aims Obesity is causally related to the development of heart failure with preserved ejection fraction (HFpEF) but complicates the diagnosis and treatment of this disorder. We aimed to determine the relationship between severity of obesity and clinical, echocardiographic and haemodynamic parameters in a large cohort of patients with documented HFpEF. Methods and results The REDUCE LAP‐HF II trial randomized 626 patients with ejection fraction ≥40% and exercise pulmonary capillary wedge pressure (PCWP) ≥25 mmHg to atrial shunt or sham procedure. We tested for associations between body mass index (BMI), clinical characteristics, cardiac structural and functional abnormalities, physical limitations, quality of life and outcomes with atrial shunt therapy. Overall, 60.9% of patients had BMI ≥30 kg/m 2 . As the severity of obesity increased, symptoms (Kansas City Cardiomyopathy Questionnaire score) and 6‐min walk distance worsened. More severe obesity was associated with lower natriuretic peptide levels despite more cardiac remodelling, higher cardiac filling pressures, and higher cardiac output. Lower cut points for E/e′ were needed to identify elevated PCWP in more obese patients. Strain measurements in all four chambers were maintained as BMI increased. Pulmonary vascular resistance at rest and exercise decreased with higher BMI. Obesity was associated with more first and recurrent heart failure events. However, there was no significant interaction between obesity and treatment effects of the atrial shunt. Conclusions Increasing severity of obesity was associated with greater cardiac remodelling, higher right and left ventricular filling pressures, higher cardiac output and increased subsequent heart failure events. Despite significant obesity, many HFpEF patients have preserved right heart and pulmonary vascular function and thus, may be appropriate candidates for atrial shunt therapy.
Related Topics
Concepts
Medicine
Internal medicine
Cardiology
Heart failure
Ejection fraction
Heart failure with preserved ejection fraction
Pulmonary wedge pressure
Obesity
Cardiac output
Body mass index
Cardiomyopathy
Hemodynamics
Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1002/ejhf.3092
- https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/ejhf.3092
- OA Status
- bronze
- Cited By
- 18
- References
- 32
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4388922100
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
-
https://openalex.org/W4388922100Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.1002/ejhf.3092Digital Object Identifier
- Title
-
Obesity in heart failure with preserved ejection fraction: Insights from the
REDUCE LAP‐HF II trialWork title - Type
-
articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2023Year of publication
- Publication date
-
2023-11-23Full publication date if available
- Authors
-
Sheldon E. Litwin, Jan Komtebedde, Tim Seidler, Barry A. Borlaug, Sebastian Winkler, Scott D. Solomon, Jean‐Christophe Eicher, Sula Mazimba, Rami Khawash, Aaron L. Sverdlov, Scott L. Hummel, Heiko Bugger, Florian Boenner, Elke S. Hoendermis, Maja Čikeš, Catherine Demers, Guillherme Silva, Vanessa van Empel, Randall C. Starling, Martin Pěnička, Donald E. Cutlip, Martin B. Leon, Dalane W. Kitzman, Dirk J. van Veldhuisen, Sanjiv J. ShahList of authors in order
- Landing page
-
https://doi.org/10.1002/ejhf.3092Publisher landing page
- PDF URL
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https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/ejhf.3092Direct link to full text PDF
- Open access
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YesWhether a free full text is available
- OA status
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bronzeOpen access status per OpenAlex
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https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/ejhf.3092Direct OA link when available
- Concepts
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Medicine, Internal medicine, Cardiology, Heart failure, Ejection fraction, Heart failure with preserved ejection fraction, Pulmonary wedge pressure, Obesity, Cardiac output, Body mass index, Cardiomyopathy, HemodynamicsTop concepts (fields/topics) attached by OpenAlex
- Cited by
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18Total citation count in OpenAlex
- Citations by year (recent)
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2025: 11, 2024: 7Per-year citation counts (last 5 years)
- References (count)
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32Number of works referenced by this work
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10Other works algorithmically related by OpenAlex
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