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

• Autor(a) principal: Cogni, Ana Lucia [UNESP]
• Data de Publicação: 2013
• Outros Autores: Farah, Elaine [UNESP], Minicucci, Marcos Ferreira [UNESP], Gaiolla, Paula Schmidt Azevedo [UNESP], Okoshi, Katashi [UNESP], Matsubara, Beatriz Bojikian [UNESP], Zanati, Silméia G. [UNESP], Paiva, Sergio A.R. [UNESP], Zornoff, Leonardo Antonio Mamede [UNESP]
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Institucional da UNESP
• Texto Completo: http://dx.doi.org/10.1016/j.nut.2012.04.020; http://hdl.handle.net/11449/74188
• topic: Coronary occlusion; Ischemia; Obesity; Prognosis; Ventricular dilatation; creatine kinase; creatine kinase MB; adult; anterior myocardial infarction; body mass; clinical evaluation; controlled study; deceleration; echocardiography; female; follow up; heart infarction size; heart left ventricle ejection fraction; heart left ventricle enddiastolic volume; heart left ventricle endsystolic volume; heart left ventricle filling; heart ventricle remodeling; heart ventricle septum; human; major clinical study; male; priority journal; prospective study; waist circumference; Aged; Body Mass Index; Echocardiography, Doppler, Color; Echocardiography, Doppler, Pulsed; Female; Heart Ventricles; Humans; Male; Middle Aged; Myocardial Infarction; Predictive Value of Tests; Prospective Studies; Ventricular Remodeling; Waist Circumference

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. © 2013 Elsevier Inc.