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Sex-specific impact of anthropometric parameters on outcomes after transcatheter edge-to-edge repair for secondary mitral regurgitation. | LitMetric

AI Article Synopsis

  • Body surface area (BSA) is found to be a better predictor of mortality than body mass index in heart failure patients, with unclear sex-specific associations affecting outcomes.
  • In a study of 1,594 heart failure patients undergoing a specific heart procedure, females showed worse prognosis at both extremes of BSA, while males had a better prognosis with higher BSA.
  • The findings highlight the need for a deeper understanding of how body measurements relate to heart failure outcomes, particularly regarding the differences between men and women.

Article Abstract

Background: Body surface area (BSA) has been reported to be the stronger predictor for prognosis than body mass index in heart failure (HF) patients. The sex-specific association of BSA with mortality has been unclear.

Methods: EuroSMR, a European multicenter registry, included patients who underwent edge-to-edge repair (TEER) for secondary mitral regurgitation (SMR). The outcome was two-year all-cause mortality.

Results: The present cohort included 1594 HF patients (age, 74 ± 10 years; male, 66%). Association of calculated BSA with two-year all-cause mortality was evaluated. Patients were classified into three BSA groups: the lowest 10% (S), the highest 10% (L), and intermediate between S and L (M). Mean BSA was 1.87 ± 0.21 m (male, 1.94 ± 0.18 m; female, 1.73 ± 0.18 m). The association of BSA with the endpoint in females showed a U-shaped curve, indicating worse prognosis for both S and L. The association in males followed a linear regression, demonstrating better prognosis for L. Hazard ratio (HR) of L to S in males was 0.43 (95% confidence interval [CI], 0.25-0.74; p = 0.002), whereas HR of L to M in females was 1.76 (95% CI, 1.11-2.78; p = 0.016) (p for interaction = 0.003).

Conclusions: Sex-specific association patterns demonstrate the complex influence of anthropomorphic factors in HF patients scheduled for TEER. Further investigation beyond simple evaluation of weight and height is needed for better comprehension of the obesity paradox and better prediction of the results of transcatheter therapy in HF patients.

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Source
http://dx.doi.org/10.1016/j.ijcard.2022.09.028DOI Listing

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