Impacto da obesidade no prognóstico de pacientes com insuficiência cardíaca de fração de ejeção reduzida de etiologia isquêmica
Autor(a) principal: | |
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Data de Publicação: | 2021 |
Outros Autores: | |
Tipo de documento: | Dissertação |
Idioma: | por |
Título da fonte: | Biblioteca Digital de Teses e Dissertações da UERJ |
Texto Completo: | http://www.bdtd.uerj.br/handle/1/18538 |
Resumo: | Introduction: The prevalence of obesity has reached epidemic proportions worldwide and is associated with widespread changes in cardiovascular structure and function. It is also known that a high body mass index (BMI) is a risk factor for the development of heart failure (HF). In contrast, several studies show a paradoxical association between obesity and the prognosis of patients with coronary artery disease (CAD) and HF, called the “obesity paradox”. According to this theory, contrary to expectations, individuals with established heart disease and overweight or obesity would have a better prognosis than individuals with low or normal weight. Objective: To evaluate the relationship between obesity and the prognosis of patients with heart failure with reduced ejection fraction (HFREF) of ischemic etiology, using overall mortality as a variable. Methods: observational, retrospective and single-center study, carried out through the analysis of medical records, in addition to telephone contacts of patients followed at the HF outpatient clinic of a quaternary hospital. Records from November 1997 to August 2019 were analyzed, with a maximum follow-up period of 10 years and a minimum of 6 months being determined. Inclusion criteria: age between 18 and 90 years, patients with HFREF of ischemic etiology, with the presence of anthropometric data in their first assessment and at least one consultation between 2010 and 2019. Demographic, clinical, laboratory, echocardiographic, therapeutic and prognostics. Results: Among the 1556 medical records of the clinic, 242 met the inclusion criteria. They were 71% male, median age 62.6 (56-70), low BMI 1%, eutrophic 35%, overweight 37%, grade I obesity 18%, grade II obesity 7% and grade III obesity 1%. Underweight and grade III obesity groups were excluded from the main analysis due to insufficient sampling. In the grade II obesity group, there was a higher incidence of alcoholism, atrial fibrillation, diabetes, and patients in NYHA functional class (FC) III, while in the other groups in FC II. In the 4 groups analyzed, there was a predominance of severe left ventricular (LV) dysfunction. Of the 242 patients, 50% died. Based on the survival curves: the obesity grade I and eutrophic groups had the best prognosis, the overweight group had an intermediate performance, and the grade II obesity group the worst curve (p=0.123). In the subgroup analysis, the grade I obesity group had a better prognosis than the grade II obesity group (p=0.033). In the multivariate analysis or MAGGIC was not able to predict mortality in different nutritional status groups, possibly due to the long follow-up time and/or due to small sample size. Conclusion: Obesity did not affect the prognosis of outpatients with HFrEF of ischemic etiology. Conclusion: Obesity did not affect the prognosis of outpatients with HFREF of ischemic etiology. |
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Rocha, Ricardo Mourilhehttp://lattes.cnpq.br/1235784620655321Albuquerque, Denilson Campos dehttp://lattes.cnpq.br/5219627521398631Sales, Ana Luiza Ferreirahttp://lattes.cnpq.br/9015944608187457Moreira, Rodrigo de Oliveirahttp://lattes.cnpq.br/8313280775887526http://lattes.cnpq.br/8896853581813966Salvino, Nathália Felix Araujodra.nathaliasalvino@gmail.com2022-10-25T14:17:57Z2021-12-08SALVINO, Nathália Felix Araujo. Impacto da obesidade no prognóstico de pacientes com insuficiência cardíaca de fração de ejeção reduzida de etiologia isquêmica. 2021. 55 f. Dissertação (Mestrado em Ciências Médicas) – Faculdade de Ciências Médicas. Universidade do Estado do Rio de Janeiro, Rio de Janeiro, 2021.http://www.bdtd.uerj.br/handle/1/18538Introduction: The prevalence of obesity has reached epidemic proportions worldwide and is associated with widespread changes in cardiovascular structure and function. It is also known that a high body mass index (BMI) is a risk factor for the development of heart failure (HF). In contrast, several studies show a paradoxical association between obesity and the prognosis of patients with coronary artery disease (CAD) and HF, called the “obesity paradox”. According to this theory, contrary to expectations, individuals with established heart disease and overweight or obesity would have a better prognosis than individuals with low or normal weight. Objective: To evaluate the relationship between obesity and the prognosis of patients with heart failure with reduced ejection fraction (HFREF) of ischemic etiology, using overall mortality as a variable. Methods: observational, retrospective and single-center study, carried out through the analysis of medical records, in addition to telephone contacts of patients followed at the HF outpatient clinic of a quaternary hospital. Records from November 1997 to August 2019 were analyzed, with a maximum follow-up period of 10 years and a minimum of 6 months being determined. Inclusion criteria: age between 18 and 90 years, patients with HFREF of ischemic etiology, with the presence of anthropometric data in their first assessment and at least one consultation between 2010 and 2019. Demographic, clinical, laboratory, echocardiographic, therapeutic and prognostics. Results: Among the 1556 medical records of the clinic, 242 met the inclusion criteria. They were 71% male, median age 62.6 (56-70), low BMI 1%, eutrophic 35%, overweight 37%, grade I obesity 18%, grade II obesity 7% and grade III obesity 1%. Underweight and grade III obesity groups were excluded from the main analysis due to insufficient sampling. In the grade II obesity group, there was a higher incidence of alcoholism, atrial fibrillation, diabetes, and patients in NYHA functional class (FC) III, while in the other groups in FC II. In the 4 groups analyzed, there was a predominance of severe left ventricular (LV) dysfunction. Of the 242 patients, 50% died. Based on the survival curves: the obesity grade I and eutrophic groups had the best prognosis, the overweight group had an intermediate performance, and the grade II obesity group the worst curve (p=0.123). In the subgroup analysis, the grade I obesity group had a better prognosis than the grade II obesity group (p=0.033). In the multivariate analysis or MAGGIC was not able to predict mortality in different nutritional status groups, possibly due to the long follow-up time and/or due to small sample size. Conclusion: Obesity did not affect the prognosis of outpatients with HFrEF of ischemic etiology. Conclusion: Obesity did not affect the prognosis of outpatients with HFREF of ischemic etiology.Introdução: A prevalência da obesidade atingiu proporções epidêmicas em todo o mundo e está associada a alterações generalizadas na estrutura e função cardiovascular. Sabe-se ainda, que um índice de massa corporal (IMC) elevado é fator de risco para o desenvolvimento de insuficiência cardíaca (IC). Em contrapartida, vários estudos mostram uma associação paradoxal entre a obesidade e o prognóstico de pacientes com doença arterial coronariana (DAC) e IC, chamado de “paradoxo da obesidade”. Por essa teoria, ao contrário da expectativa, indivíduos com doença cardíaca estabelecida e excesso de peso ou obesidade apresentariam melhor prognóstico do que indivíduos com peso baixo ou normal. Objetivo: Avaliar a relação entre a obesidade e o prognóstico de pacientes com insuficiência cardíaca de fração de ejeção reduzida (ICFER) de etiologia isquêmica, utilizando como variável a mortalidade geral. Métodos: estudo observacional, retrospectivo e, unicêntrico, realizado através da análise de registros médicos, além de contatos telefônicos dos pacientes acompanhados no ambulatório de IC de um hospital quaternário. Foram analisados registros de novembro de 1997 a agosto de 2019, sendo determinado como tempo de seguimento máximo o período de 10 anos e mínimo de 6 meses. Critérios de inclusão: idade entre 18 e 90 anos, portadores de ICFER de etiologia isquêmica, com presença de dados antropométricos em sua primeira avaliação e ao menos uma consulta entre 2010 e 2019. Foram analisadas variáveis demográficas, clínicas, laboratoriais, ecocardiográficas, terapêuticas e prognósticas. Resultados: Entre os 1556 prontuários do ambulatório, 242 apresentaram os critérios de inclusão. Eram 71% do sexo masculino, mediana de idade 62,6 (56-70), IMC baixo peso 1%, eutrófico 35%, sobrepeso 37%, obesidade grau I 18%, obesidade grau II 7% e obesidade grau III 1%. Foram excluídos das análises principais os grupos baixo peso e obesidade grau III devido a amostragem insuficiente. No grupo obesidade grau II foi observado maior incidência de alcoolismo, fibrilação atrial, diabetes e pacientes em classe funcional (CF) III da NYHA, enquanto nos demais grupos em CF II. Nos 4 grupos analisados, existia predomínio de disfunção grave do ventrículo esquerdo (VE). Dos 242 pacientes, 50% evoluíram com óbito. Com base nas curvas de sobrevida: os grupos obesidade grau I e eutrófico apresentaram melhor prognóstico, o grupo sobrepeso apresentou desempenho intermediário, e o grupo obesidade grau II a pior curva, (p=0,123). Na análise de subgrupo, o grupo obesidade grau I apresentou prognóstico melhor que o grupo e obesidade grau II (p=0,033). Na análise multivariada o MAGGIC escore não foi capaz de predizer mortalidade nos diferentes grupos de estado nutricional, possivelmente devido ao longo tempo de seguimento e/ou devido ao N pequeno. Conclusão: A obesidade não interferiu no prognóstico de pacientes ambulatoriais com ICFER de etiologia isquêmica.Submitted by Heloísa CB/A (helobdtd@gmail.com) on 2022-10-25T14:17:57Z No. of bitstreams: 1 Dissertação - Nathália Felix Araujo Salvino - 2021 - Completo.pdf: 1195142 bytes, checksum: 776a668847e34a6123d439933d251802 (MD5)Made available in DSpace on 2022-10-25T14:17:57Z (GMT). No. of bitstreams: 1 Dissertação - Nathália Felix Araujo Salvino - 2021 - Completo.pdf: 1195142 bytes, checksum: 776a668847e34a6123d439933d251802 (MD5) Previous issue date: 2021-12-08application/pdfporUniversidade do Estado do Rio de JaneiroPrograma de Pós-Graduação em Ciências MédicasUERJBrasilCentro Biomédico::Faculdade de Ciências MédicasObesity paradoxHeart failureObesityParadoxo da obesidadeInsuficiência cardíacaObesidadeCIENCIAS DA SAUDE::MEDICINA::CLINICA MEDICA::CARDIOLOGIAImpacto da obesidade no prognóstico de pacientes com insuficiência cardíaca de fração de ejeção reduzida de etiologia isquêmicaImpact of obesity on the prognosis of patients with heart failure with reduced ejection fraction of ischemic etiologyinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisinfo:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da UERJinstname:Universidade do Estado do Rio de Janeiro (UERJ)instacron:UERJORIGINALDissertação - Nathália Felix Araujo Salvino - 2021 - Completo.pdfDissertação - Nathália Felix Araujo Salvino - 2021 - Completo.pdfapplication/pdf1195142http://www.bdtd.uerj.br/bitstream/1/18538/2/Disserta%C3%A7%C3%A3o+-+Nath%C3%A1lia+Felix+Araujo+Salvino+-+2021+-+Completo.pdf776a668847e34a6123d439933d251802MD52LICENSElicense.txtlicense.txttext/plain; charset=utf-82123http://www.bdtd.uerj.br/bitstream/1/18538/1/license.txte5502652da718045d7fcd832b79fca29MD511/185382024-02-26 15:59:52.527oai:www.bdtd.uerj.br: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Biblioteca Digital de Teses e Dissertaçõeshttp://www.bdtd.uerj.br/PUBhttps://www.bdtd.uerj.br:8443/oai/requestbdtd.suporte@uerj.bropendoar:29032024-02-26T18:59:52Biblioteca Digital de Teses e Dissertações da UERJ - Universidade do Estado do Rio de Janeiro (UERJ)false |
dc.title.por.fl_str_mv |
Impacto da obesidade no prognóstico de pacientes com insuficiência cardíaca de fração de ejeção reduzida de etiologia isquêmica |
dc.title.alternative.eng.fl_str_mv |
Impact of obesity on the prognosis of patients with heart failure with reduced ejection fraction of ischemic etiology |
title |
Impacto da obesidade no prognóstico de pacientes com insuficiência cardíaca de fração de ejeção reduzida de etiologia isquêmica |
spellingShingle |
Impacto da obesidade no prognóstico de pacientes com insuficiência cardíaca de fração de ejeção reduzida de etiologia isquêmica Salvino, Nathália Felix Araujo Obesity paradox Heart failure Obesity Paradoxo da obesidade Insuficiência cardíaca Obesidade CIENCIAS DA SAUDE::MEDICINA::CLINICA MEDICA::CARDIOLOGIA |
title_short |
Impacto da obesidade no prognóstico de pacientes com insuficiência cardíaca de fração de ejeção reduzida de etiologia isquêmica |
title_full |
Impacto da obesidade no prognóstico de pacientes com insuficiência cardíaca de fração de ejeção reduzida de etiologia isquêmica |
title_fullStr |
Impacto da obesidade no prognóstico de pacientes com insuficiência cardíaca de fração de ejeção reduzida de etiologia isquêmica |
title_full_unstemmed |
Impacto da obesidade no prognóstico de pacientes com insuficiência cardíaca de fração de ejeção reduzida de etiologia isquêmica |
title_sort |
Impacto da obesidade no prognóstico de pacientes com insuficiência cardíaca de fração de ejeção reduzida de etiologia isquêmica |
author |
Salvino, Nathália Felix Araujo |
author_facet |
Salvino, Nathália Felix Araujo dra.nathaliasalvino@gmail.com |
author_role |
author |
author2 |
dra.nathaliasalvino@gmail.com |
author2_role |
author |
dc.contributor.advisor1.fl_str_mv |
Rocha, Ricardo Mourilhe |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/1235784620655321 |
dc.contributor.referee1.fl_str_mv |
Albuquerque, Denilson Campos de |
dc.contributor.referee1Lattes.fl_str_mv |
http://lattes.cnpq.br/5219627521398631 |
dc.contributor.referee2.fl_str_mv |
Sales, Ana Luiza Ferreira |
dc.contributor.referee2Lattes.fl_str_mv |
http://lattes.cnpq.br/9015944608187457 |
dc.contributor.referee3.fl_str_mv |
Moreira, Rodrigo de Oliveira |
dc.contributor.referee3Lattes.fl_str_mv |
http://lattes.cnpq.br/8313280775887526 |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/8896853581813966 |
dc.contributor.author.fl_str_mv |
Salvino, Nathália Felix Araujo dra.nathaliasalvino@gmail.com |
contributor_str_mv |
Rocha, Ricardo Mourilhe Albuquerque, Denilson Campos de Sales, Ana Luiza Ferreira Moreira, Rodrigo de Oliveira |
dc.subject.eng.fl_str_mv |
Obesity paradox Heart failure Obesity |
topic |
Obesity paradox Heart failure Obesity Paradoxo da obesidade Insuficiência cardíaca Obesidade CIENCIAS DA SAUDE::MEDICINA::CLINICA MEDICA::CARDIOLOGIA |
dc.subject.por.fl_str_mv |
Paradoxo da obesidade Insuficiência cardíaca Obesidade |
dc.subject.cnpq.fl_str_mv |
CIENCIAS DA SAUDE::MEDICINA::CLINICA MEDICA::CARDIOLOGIA |
description |
Introduction: The prevalence of obesity has reached epidemic proportions worldwide and is associated with widespread changes in cardiovascular structure and function. It is also known that a high body mass index (BMI) is a risk factor for the development of heart failure (HF). In contrast, several studies show a paradoxical association between obesity and the prognosis of patients with coronary artery disease (CAD) and HF, called the “obesity paradox”. According to this theory, contrary to expectations, individuals with established heart disease and overweight or obesity would have a better prognosis than individuals with low or normal weight. Objective: To evaluate the relationship between obesity and the prognosis of patients with heart failure with reduced ejection fraction (HFREF) of ischemic etiology, using overall mortality as a variable. Methods: observational, retrospective and single-center study, carried out through the analysis of medical records, in addition to telephone contacts of patients followed at the HF outpatient clinic of a quaternary hospital. Records from November 1997 to August 2019 were analyzed, with a maximum follow-up period of 10 years and a minimum of 6 months being determined. Inclusion criteria: age between 18 and 90 years, patients with HFREF of ischemic etiology, with the presence of anthropometric data in their first assessment and at least one consultation between 2010 and 2019. Demographic, clinical, laboratory, echocardiographic, therapeutic and prognostics. Results: Among the 1556 medical records of the clinic, 242 met the inclusion criteria. They were 71% male, median age 62.6 (56-70), low BMI 1%, eutrophic 35%, overweight 37%, grade I obesity 18%, grade II obesity 7% and grade III obesity 1%. Underweight and grade III obesity groups were excluded from the main analysis due to insufficient sampling. In the grade II obesity group, there was a higher incidence of alcoholism, atrial fibrillation, diabetes, and patients in NYHA functional class (FC) III, while in the other groups in FC II. In the 4 groups analyzed, there was a predominance of severe left ventricular (LV) dysfunction. Of the 242 patients, 50% died. Based on the survival curves: the obesity grade I and eutrophic groups had the best prognosis, the overweight group had an intermediate performance, and the grade II obesity group the worst curve (p=0.123). In the subgroup analysis, the grade I obesity group had a better prognosis than the grade II obesity group (p=0.033). In the multivariate analysis or MAGGIC was not able to predict mortality in different nutritional status groups, possibly due to the long follow-up time and/or due to small sample size. Conclusion: Obesity did not affect the prognosis of outpatients with HFrEF of ischemic etiology. Conclusion: Obesity did not affect the prognosis of outpatients with HFREF of ischemic etiology. |
publishDate |
2021 |
dc.date.issued.fl_str_mv |
2021-12-08 |
dc.date.accessioned.fl_str_mv |
2022-10-25T14:17:57Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/masterThesis |
format |
masterThesis |
status_str |
publishedVersion |
dc.identifier.citation.fl_str_mv |
SALVINO, Nathália Felix Araujo. Impacto da obesidade no prognóstico de pacientes com insuficiência cardíaca de fração de ejeção reduzida de etiologia isquêmica. 2021. 55 f. Dissertação (Mestrado em Ciências Médicas) – Faculdade de Ciências Médicas. Universidade do Estado do Rio de Janeiro, Rio de Janeiro, 2021. |
dc.identifier.uri.fl_str_mv |
http://www.bdtd.uerj.br/handle/1/18538 |
identifier_str_mv |
SALVINO, Nathália Felix Araujo. Impacto da obesidade no prognóstico de pacientes com insuficiência cardíaca de fração de ejeção reduzida de etiologia isquêmica. 2021. 55 f. Dissertação (Mestrado em Ciências Médicas) – Faculdade de Ciências Médicas. Universidade do Estado do Rio de Janeiro, Rio de Janeiro, 2021. |
url |
http://www.bdtd.uerj.br/handle/1/18538 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
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Universidade do Estado do Rio de Janeiro |
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Programa de Pós-Graduação em Ciências Médicas |
dc.publisher.initials.fl_str_mv |
UERJ |
dc.publisher.country.fl_str_mv |
Brasil |
dc.publisher.department.fl_str_mv |
Centro Biomédico::Faculdade de Ciências Médicas |
publisher.none.fl_str_mv |
Universidade do Estado do Rio de Janeiro |
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Biblioteca Digital de Teses e Dissertações da UERJ - Universidade do Estado do Rio de Janeiro (UERJ) |
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bdtd.suporte@uerj.br |
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