TY - JOUR
T1 - Effect of obesity on outcomes in patients undergoing implantation of continuous-flow left ventricular assist devices
AU - Volkovicher, Nastasya
AU - Kurihara, Chitaru
AU - Critsinelis, Andre
AU - Kawabori, Masashi
AU - Sugiura, Tadahisa
AU - Manon, Marcos
AU - Civitello, Andrew B.
AU - Morgan, Jeffrey A.
N1 - Funding Information:
The authors thank Drs. MacArthur A. Elayda and Suwei Wang of the Department of Biostatistics and Epidemiology at the Texas Heart Institute for their timely help in analyzing our large dataset. The Section of Scientific Publications at the Texas Heart Institute provided editorial support. The authors declare that they have no conflict of interest.
Publisher Copyright:
© 2017, The Japanese Society for Artificial Organs.
PY - 2018/6/1
Y1 - 2018/6/1
N2 - The purpose of this study was to analyze the effect of obesity on outcomes after continuous-flow left ventricular assist device (CF-LVAD) implantation. A single-center retrospective analysis was performed on 526 chronic heart failure patients who were implanted with the HeartMate II CF-LVAD (n = 403) or HeartWare HVAD (n = 123) between November 2003 and March 2016. Patients were stratified into 4 groups based on BMI: underweight (< 18.5 kg/m2, n = 18, 3.4%), normal-weight (18.5–25 kg/m2, n = 173, 32.9%), overweight (25–30 kg/m2, n = 182, 30.2%), and obese (> 30 kg/m2, n = 153, 33.5%). The underweight group was excluded because of its small sample size. Records were reviewed to determine the incidence of postoperative complications and survival. Survival at 1, 6, 12, and 24 months were similar among normal-weight (91.3, 84.4, 76.3, and 67.6%), overweight (90.4, 80.8, 76.5, and 69.6%), and obese patients (90.7, 74.7, 65.3, and 61.3%, p = 0.24). Additionally, obesity was not a significant predictor of mortality in Cox proportional hazard models (hazard ratio 0.98, 95% confidence interval 0.766–1.277, p = 0.13). These findings suggest that appropriately selected obese patients receive similar survival benefit from CF-LVADs compared to non-obese patients, and obesity should not serve as a contraindication to CF-LVAD implantation.
AB - The purpose of this study was to analyze the effect of obesity on outcomes after continuous-flow left ventricular assist device (CF-LVAD) implantation. A single-center retrospective analysis was performed on 526 chronic heart failure patients who were implanted with the HeartMate II CF-LVAD (n = 403) or HeartWare HVAD (n = 123) between November 2003 and March 2016. Patients were stratified into 4 groups based on BMI: underweight (< 18.5 kg/m2, n = 18, 3.4%), normal-weight (18.5–25 kg/m2, n = 173, 32.9%), overweight (25–30 kg/m2, n = 182, 30.2%), and obese (> 30 kg/m2, n = 153, 33.5%). The underweight group was excluded because of its small sample size. Records were reviewed to determine the incidence of postoperative complications and survival. Survival at 1, 6, 12, and 24 months were similar among normal-weight (91.3, 84.4, 76.3, and 67.6%), overweight (90.4, 80.8, 76.5, and 69.6%), and obese patients (90.7, 74.7, 65.3, and 61.3%, p = 0.24). Additionally, obesity was not a significant predictor of mortality in Cox proportional hazard models (hazard ratio 0.98, 95% confidence interval 0.766–1.277, p = 0.13). These findings suggest that appropriately selected obese patients receive similar survival benefit from CF-LVADs compared to non-obese patients, and obesity should not serve as a contraindication to CF-LVAD implantation.
KW - Body mass index (BMI)
KW - Heart failure
KW - Left ventricular assist device (LVAD)
KW - Obesity
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U2 - 10.1007/s10047-017-1013-2
DO - 10.1007/s10047-017-1013-2
M3 - Article
C2 - 29372417
AN - SCOPUS:85040916784
SN - 1434-7229
VL - 21
SP - 180
EP - 187
JO - Journal of Artificial Organs
JF - Journal of Artificial Organs
IS - 2
ER -
