Effects of Weight Loss in Outpatients With Mild Chronic Heart Failure: Findings From the J-MELODIC Study

Okuhara, Yoshitaka; Asakura, Masanori; Orihara, Yoshiyuki; Naito, Yoshiro; Tsujino, Takeshi; Ishihara, Masaharu; Masuyama, Tohru; investigators, J-Melodic study

doi:10.1016/j.cardfail.2018.11.003

Cited by 16 publications

(24 citation statements)

References 16 publications

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“…In addition, unintentional weight loss has been shown to be detrimental in patients with HF, even in patients with mild HF in whom weight loss of 5% or more was a significant predictor of CV death or hospitalization for HF. 54 At the time of the 2013 ACC/AHA/HFSA (Heart Failure Society of America) HF guidelines, there were no large-scale studies demonstrating safety or efficacy of weight loss with diet, exercise or bariatric surgery in obese HF patients. 50 …”

Section: Weight Lossmentioning

confidence: 99%

Implications of obesity across the heart failure continuum

Elagizi

Carbone

Lavie

et al. 2020

Progress in Cardiovascular Diseases

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The obesity paradox, which suggests a survival advantage for the obese in heart failure (HF) has sparked debate in the medical community. Studies demonstrate a survival advantage in obese patients with HF, including those with advanced HF requiring continuous inotropic support for palliation or disease modifying therapy with a left ventricular assist device (LVAD) or heart transplantation (HT). Importantly, the obesity paradox is affected by the level of cardiorespiratory fitness (CRF). It is now recommended that HF patients with body mass index ≥35 kg/m 2 achieve at least 5–10% weight loss, in order to improve symptoms and cardiac function, though more robust data are urgently needed. CRF may be the single best predictor of overall health and small improvements in fitness levels may lead to improved outcomes in HF. In addition to implications of obesity in chronic HF, we also discuss management of obese patients with advanced HF and their implications for therapies such as LVAD implantation and HT.

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Section: Weight Lossmentioning

confidence: 99%

Implications of obesity across the heart failure continuum

Elagizi

Carbone

Lavie

et al. 2020

Progress in Cardiovascular Diseases

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“…3,4 The prevalence of unintentional weight loss, defined as a loss of 6% or more of body weight, ranges from 11.2% to 17% in patients with CHF. 5,6 The prognostic values of weight loss for predicting mortality are controversial in patients with CHF. 5,7 Therefore, we conducted this meta-analysis to evaluate the association of weight loss with cardiovascular and all-cause mortality risk in these patients.…”

mentioning

confidence: 99%

“…5,6 The prognostic values of weight loss for predicting mortality are controversial in patients with CHF. 5,7 Therefore, we conducted this meta-analysis to evaluate the association of weight loss with cardiovascular and all-cause mortality risk in these patients.…”

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confidence: 99%

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Prediction of all-cause and cardiovascular mortality with weight loss in patients with chronic heart failure: a meta-analysis

Fan¹,

Gu²,

Zou³

2020

European Journal of Preventive Cardiology

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“…We retrospectively analyzed data from the Japanese multicenter J-MELODIC study to evaluate the effects of LVEF change in outpatients with CHF. The details of the J-MELODIC study design have previously been described 9,10 . Briefly, the study population comprised 320 outpatients with New York Heart Association (NYHA) II or III CHF and who received standard therapy including diuretics, renin–angiotensin–aldosterone system inhibitors (RAASi), and β-blockers (BB).…”

Section: Methodsmentioning

confidence: 99%

Reduction in Left Ventricular Ejection Fraction is Associated with Subsequent Cardiac Events in Outpatients with Chronic Heart Failure

Okuhara

Asakura

Orihara

et al. 2019

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Left ventricular ejection fraction (LVEF) is critical for determining the prognosis and treatment of patients with heart failure (HF). However, the influence of serial LVEF changes in patients with stable chronic HF (CHF) has not yet been completely investigated. We analyzed data of 263 outpatients with CHF from the J-MELODIC study cohort and evaluated the frequency of cardiac events. We stratified patients into tertiles based on the relative difference in LVEF in 1 year and that at baseline. We found a significant difference in the cardiac event rate among the three groups (log-rank test, p = 0.042). We identified a relative 11% LVEF reduction as the optimal cutoff value based on the receiver operating characteristics analysis. LVEF (OR, 1.04; 95% CI, 1.01–1.07; p = 0.015) and E/e′ (OR, 1.06; 95% CI, 1.01–1.12; p = 0.023) at baseline were predictors of >11% LVEF reduction. After adjusting the variables including age and sex, >11% LVEF reduction was an independent predictor of subsequent cardiac events (HR, 5.79; 95% CI, 2.49–13.2; p < 0.001). In conclusion, patients with 1-year relative >11% LVEF reduction may have subsequent worsening outcomes. Such patients should be carefully followed-up as high risk population for development of cardiac events.

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Effects of Weight Loss in Outpatients With Mild Chronic Heart Failure: Findings From the J-MELODIC Study

Cited by 16 publications

References 16 publications

Implications of obesity across the heart failure continuum

Implications of obesity across the heart failure continuum

Prediction of all-cause and cardiovascular mortality with weight loss in patients with chronic heart failure: a meta-analysis

Reduction in Left Ventricular Ejection Fraction is Associated with Subsequent Cardiac Events in Outpatients with Chronic Heart Failure

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