Long-Term Impact of Body Mass Index on Survival of Patients Undergoing Cardiac Resynchronization Therapy: A Multi-Centre Study

Obesity is a risk factor for heart failure (HF), but its presence among HF patients may be associated with favorable outcomes. We investigated the long-term outcomes across different body mass index (BMI) groups, after cardiac resynchronization therapy (CRT), and whether defibrillator back-up (CRT-D) confers survival benefit. One thousand two-hundred seventy-seven (1,277) consecutive (mean age: 67.0 ± 12.7 years, 44.1% women, mean BMI: 28.3 5.6 Kg/m2) who underwent CRT implantation in 5 centers between 2000-2014 were followed-up median period of 4.9 years (IQR 2.4 to 7.5). More than 10% had follow-up ≥10 years. Patients classified according BMI as normal: <25.0 Kg/m2, overweight: 25.0 29.9 Kg/m2 obese: ≥30.0 Kg/m2. 364 normal weight, 494 overweight 419 obese. CRT-Ds implanted >75% patients, used less frequently obese individuals. The composite endpoint all-cause mortality or transplant/left ventricular assist device (LVAD) occurred 50.9% patients. At 10-year follow-up, quarter lowest highest categories still alive free from transplant/LVAD. After adjustment 25 (HR = 0.73 [95%CI 0.56 0.96], p 0.023) use CRT-D 0.74 [95% CI 0.55 0.98], 0.039) independent predictors LVAD/heart transplant. at time implant was independently favourable survival. Use improved irrespective class.