Background: Heart failure patients with higher body mass index (BMI) exhibit better clinical outcomes. Therefore, we assessed whether the BMI can predict left ventricular ejection fraction (EF) improvement following heart failure.

Methods and Results: We included 184 patients newly diagnosed with dilated cardiomyopathy and reduced EF in our center and who underwent follow-up examination of EF via echocardiography after 6 months. The EF improved at 6 months in 88 participants, who were included in the heart failure with recovered EF (HFrecEF) subgroup. Patients in whom the EF remained reduced were included in the heart failure with persistently reduced EF (persistent HFrEF) subgroup. Our analyses revealed that EF increase correlated with age (r = −0.254, P = 0.001), left ventricular diastolic dimension (LVDD; r = −0.210, P = 0.004), diabetes (P = 0.034), brain natriuretic peptide (r = −0.199, P = 0.007), and BMI grade (P = 0.000). BMI grade was significantly associated with elevated EF after adjustment for other variables (P = 0.001). On multivariable analysis, compared to patients with persistent HFrEF, those with HFrecEF had higher BMI [odds ratio (OR) = 2.342 per one standard deviation increase; P = 0.001] and lower LVDD (OR = 0.466 per one standard deviation increase; P = 0.001). ROC-curve analysis data showed that BMI > 22.66 kg/m2 (sensitivity 84.1%, specificity 59.4%, AUC 0.745, P = 0.000) indicate high probability of EF recovery in 6 months.

Conclusions: Our data suggest that higher BMI is strongly correlated with the recovered EF and that BMI is an effective predictor of EF improvement in patients with heart failure and reduced EF.

背景：体重指数（BMI）较高的心力衰竭患者表现出更好的临床结果。因此，我们评估了 BMI 是否可以预测心力衰竭后左心室射血分数 (EF) 的改善。

方法和结果：我们纳入了我们中心新诊断为扩张型心肌病和 EF 降低的 184 名患者，他们在 6 个月后通过超声心动图进行了 EF 随访检查。88 名参与者的 EF 在 6 个月时有所改善，他们被包括在 EF 恢复的心力衰竭 (HFrecEF) 亚组中。EF 保持降低的患者被包括在 EF 持续降低的心力衰竭（持续性 HFrEF）亚组中。我们的分析表明，EF 增加与年龄相关（r = -0.254， 磷 = 0.001), 左心室舒张尺寸 (LVDD; r = -0.210， 磷 = 0.004），糖尿病（磷 = 0.034），脑钠肽（r = -0.199， 磷 = 0.007) 和 BMI 等级 (磷= 0.000）。调整其他变量后，BMI等级与EF升高显着相关（磷= 0.001）。在多变量分析中，与持续性 HFrEF 患者相比，HFrecEF 患者具有更高的 BMI [比值比 (OR) = 2.342，每增加一个标准差；磷 = 0.001] 和更低的 LVDD（每增加一个标准偏差，OR = 0.466； 磷= 0.001）。ROC-曲线分析数据显示BMI > 22.66 kg/m2（敏感性84.1%，特异性59.4%，AUC 0.745，磷 = 0.000) 表示 6 个月内 EF 恢复的可能性很高。

结论： 我们的数据表明，较高的 BMI 与恢复的 EF 密切相关，并且 BMI 是心力衰竭和 EF 降低患者 EF 改善的有效预测指标。