Heart transplantation in heart failure

The prognostic importance of body mass index at time of surgery and subsequent weight changes

Andrew L. Clark, Christoph Knosalla, Emma Birks, Matthias Loebe, Constantinos H. Davos, Sui Tsang, Abdissa Negassa, Magdi Yacoub, Roland Hetzer, Andrew J S Coats, Stefan D. Anker

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Background: Heart transplantation is an important treatment for end-stage chronic heart failure. We studied the effect of body mass index (BMI), and the effect of subsequent weight change, on survival following transplantation in 1902 consecutive patients. Methods and results: Patients were recruited from: London (n = 553), Berlin (N = 971) and Boston (N = 378). Patients suitable for transplantation due to symptoms, low left ventricular ejection fraction (≤ 30%) and peak oxygen consumption (≤ 16 ml kg- 1 min- 1) (N = 237) were used as a comparator. In surviving transplanted patients, average duration of follow-up was 80 (SD 34) months. There were 805 deaths. One year survival was 72.7% (95% CI 72.68-72.72) and 5 year survival was 60.96% (61.94-61.99). Baseline BMI did not effect survival either as a continuous variable (hazard ratio (95% CI): 1.02; 0.99-1.04). Weight loss between transplant and 3 months was associated with worse survival (HR (95% CI) 2.6 (1.42-4.74)) compared with those who gained weight. In the reference group, increasing body mass index was related to survival. Conclusions: Chronic heart failure patients with very low body weight can be transplanted successfully. The presence of underweight need not be an exclusion criterion for heart transplantation. Underweight patients appear to have a greater benefit from transplantation. Body weight increases after transplantation are not associated with adverse prognosis.

Original languageEnglish (US)
Pages (from-to)839-844
Number of pages6
JournalEuropean Journal of Heart Failure
Volume9
Issue number8
DOIs
StatePublished - Aug 2007

Fingerprint

Heart Transplantation
Body Mass Index
Heart Failure
Weights and Measures
Survival
Transplantation
Thinness
Body Weight
Berlin
Oxygen Consumption
Stroke Volume
Weight Loss
Transplants

Keywords

  • Heart failure
  • Nutrition
  • Obesity
  • Transplantation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Heart transplantation in heart failure : The prognostic importance of body mass index at time of surgery and subsequent weight changes. / Clark, Andrew L.; Knosalla, Christoph; Birks, Emma; Loebe, Matthias; Davos, Constantinos H.; Tsang, Sui; Negassa, Abdissa; Yacoub, Magdi; Hetzer, Roland; Coats, Andrew J S; Anker, Stefan D.

In: European Journal of Heart Failure, Vol. 9, No. 8, 08.2007, p. 839-844.

Research output: Contribution to journalArticle

Clark, AL, Knosalla, C, Birks, E, Loebe, M, Davos, CH, Tsang, S, Negassa, A, Yacoub, M, Hetzer, R, Coats, AJS & Anker, SD 2007, 'Heart transplantation in heart failure: The prognostic importance of body mass index at time of surgery and subsequent weight changes', European Journal of Heart Failure, vol. 9, no. 8, pp. 839-844. https://doi.org/10.1016/j.ejheart.2007.03.010
Clark, Andrew L. ; Knosalla, Christoph ; Birks, Emma ; Loebe, Matthias ; Davos, Constantinos H. ; Tsang, Sui ; Negassa, Abdissa ; Yacoub, Magdi ; Hetzer, Roland ; Coats, Andrew J S ; Anker, Stefan D. / Heart transplantation in heart failure : The prognostic importance of body mass index at time of surgery and subsequent weight changes. In: European Journal of Heart Failure. 2007 ; Vol. 9, No. 8. pp. 839-844.
@article{5df14ba025b64eb2931c761cbf9166bf,
title = "Heart transplantation in heart failure: The prognostic importance of body mass index at time of surgery and subsequent weight changes",
abstract = "Background: Heart transplantation is an important treatment for end-stage chronic heart failure. We studied the effect of body mass index (BMI), and the effect of subsequent weight change, on survival following transplantation in 1902 consecutive patients. Methods and results: Patients were recruited from: London (n = 553), Berlin (N = 971) and Boston (N = 378). Patients suitable for transplantation due to symptoms, low left ventricular ejection fraction (≤ 30{\%}) and peak oxygen consumption (≤ 16 ml kg- 1 min- 1) (N = 237) were used as a comparator. In surviving transplanted patients, average duration of follow-up was 80 (SD 34) months. There were 805 deaths. One year survival was 72.7{\%} (95{\%} CI 72.68-72.72) and 5 year survival was 60.96{\%} (61.94-61.99). Baseline BMI did not effect survival either as a continuous variable (hazard ratio (95{\%} CI): 1.02; 0.99-1.04). Weight loss between transplant and 3 months was associated with worse survival (HR (95{\%} CI) 2.6 (1.42-4.74)) compared with those who gained weight. In the reference group, increasing body mass index was related to survival. Conclusions: Chronic heart failure patients with very low body weight can be transplanted successfully. The presence of underweight need not be an exclusion criterion for heart transplantation. Underweight patients appear to have a greater benefit from transplantation. Body weight increases after transplantation are not associated with adverse prognosis.",
keywords = "Heart failure, Nutrition, Obesity, Transplantation",
author = "Clark, {Andrew L.} and Christoph Knosalla and Emma Birks and Matthias Loebe and Davos, {Constantinos H.} and Sui Tsang and Abdissa Negassa and Magdi Yacoub and Roland Hetzer and Coats, {Andrew J S} and Anker, {Stefan D.}",
year = "2007",
month = "8",
doi = "10.1016/j.ejheart.2007.03.010",
language = "English (US)",
volume = "9",
pages = "839--844",
journal = "European Journal of Heart Failure",
issn = "1388-9842",
publisher = "Oxford University Press",
number = "8",

}

TY - JOUR

T1 - Heart transplantation in heart failure

T2 - The prognostic importance of body mass index at time of surgery and subsequent weight changes

AU - Clark, Andrew L.

AU - Knosalla, Christoph

AU - Birks, Emma

AU - Loebe, Matthias

AU - Davos, Constantinos H.

AU - Tsang, Sui

AU - Negassa, Abdissa

AU - Yacoub, Magdi

AU - Hetzer, Roland

AU - Coats, Andrew J S

AU - Anker, Stefan D.

PY - 2007/8

Y1 - 2007/8

N2 - Background: Heart transplantation is an important treatment for end-stage chronic heart failure. We studied the effect of body mass index (BMI), and the effect of subsequent weight change, on survival following transplantation in 1902 consecutive patients. Methods and results: Patients were recruited from: London (n = 553), Berlin (N = 971) and Boston (N = 378). Patients suitable for transplantation due to symptoms, low left ventricular ejection fraction (≤ 30%) and peak oxygen consumption (≤ 16 ml kg- 1 min- 1) (N = 237) were used as a comparator. In surviving transplanted patients, average duration of follow-up was 80 (SD 34) months. There were 805 deaths. One year survival was 72.7% (95% CI 72.68-72.72) and 5 year survival was 60.96% (61.94-61.99). Baseline BMI did not effect survival either as a continuous variable (hazard ratio (95% CI): 1.02; 0.99-1.04). Weight loss between transplant and 3 months was associated with worse survival (HR (95% CI) 2.6 (1.42-4.74)) compared with those who gained weight. In the reference group, increasing body mass index was related to survival. Conclusions: Chronic heart failure patients with very low body weight can be transplanted successfully. The presence of underweight need not be an exclusion criterion for heart transplantation. Underweight patients appear to have a greater benefit from transplantation. Body weight increases after transplantation are not associated with adverse prognosis.

AB - Background: Heart transplantation is an important treatment for end-stage chronic heart failure. We studied the effect of body mass index (BMI), and the effect of subsequent weight change, on survival following transplantation in 1902 consecutive patients. Methods and results: Patients were recruited from: London (n = 553), Berlin (N = 971) and Boston (N = 378). Patients suitable for transplantation due to symptoms, low left ventricular ejection fraction (≤ 30%) and peak oxygen consumption (≤ 16 ml kg- 1 min- 1) (N = 237) were used as a comparator. In surviving transplanted patients, average duration of follow-up was 80 (SD 34) months. There were 805 deaths. One year survival was 72.7% (95% CI 72.68-72.72) and 5 year survival was 60.96% (61.94-61.99). Baseline BMI did not effect survival either as a continuous variable (hazard ratio (95% CI): 1.02; 0.99-1.04). Weight loss between transplant and 3 months was associated with worse survival (HR (95% CI) 2.6 (1.42-4.74)) compared with those who gained weight. In the reference group, increasing body mass index was related to survival. Conclusions: Chronic heart failure patients with very low body weight can be transplanted successfully. The presence of underweight need not be an exclusion criterion for heart transplantation. Underweight patients appear to have a greater benefit from transplantation. Body weight increases after transplantation are not associated with adverse prognosis.

KW - Heart failure

KW - Nutrition

KW - Obesity

KW - Transplantation

UR - http://www.scopus.com/inward/record.url?scp=34547807082&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=34547807082&partnerID=8YFLogxK

U2 - 10.1016/j.ejheart.2007.03.010

DO - 10.1016/j.ejheart.2007.03.010

M3 - Article

VL - 9

SP - 839

EP - 844

JO - European Journal of Heart Failure

JF - European Journal of Heart Failure

SN - 1388-9842

IS - 8

ER -