How does bmi influence heart failure programme outcomes-testing the obesity paradox

Introduction A complex physiological relationship exists between obesity and heart failure (HF) with many large-scale studies reporting a paradoxical improvement in cardiovascular (CV) mortality in obese patients. Many of these studies retrospectively analyzed RCT trials not designed to investigate the role of obesity in HF outcomes. We aim to establish if different outcomes exist after HF programme completion based on body mass index (BMI). Methods A multi-centre retrospective observational study was carried out in 3 hospitals’ HF clinics. New patients referred to each HF service over a 12 month period were reviewed, or in a 24 month period in one centre, with a left ventricular ejection fraction (LVEF) 30). Results 93 patients were included for analysis and a follow up of (mean (±SD) 16.5 months (±8.8) was obtained. 63 (67.7%) had a BMI 30. Obese patients were more likely to be male (p=0.03), diabetic (p=0.05) and have hypertension (p Conclusion Despite higher rates of diabetes and hypertension in obese patients, there was no significant difference in mortality, LVEF improvement and NT-proBNP improvement following HF programme completion between the 2 groups. However, obese patients had significantly less HF hospitalisations during the study period than non-obese patients.