Satish Kenchaiah, M.D., Jane C. Evans, D.Sc., Daniel Levy, M.D., Peter W.F. Wilson, M.D., Emelia J. Benjamin, M.D., Martin G. Larson, S.D., William B. Kannel, M.D., M.P.H., and Ramachandran S. Vasan, M.D.
Background Extreme obesity is recognized to be a risk factorfor heart failure. It is unclear whether overweight and lesserdegrees of obesity also pose a risk.
Methods We investigated the relation between the body-mass index(the weight in kilograms divided by the square of the heightin meters) and the incidence of heart failure among 5881 participantsin the Framingham Heart Study (mean age, 55 years; 54 percentwomen). With the use of Cox proportional-hazards models, thebody-mass index was evaluated both as a continuous variableand as a categorical variable (normal, 18.5 to 24.9; overweight,25.0 to 29.9; and obese, 30.0 or more).
Conclusions In our large, community-based sample, increasedbody-mass index was associated with an increased risk of heartfailure. Given the high prevalence of obesity in the UnitedStates, strategies to promote optimal body weight may reducethe population burden of heart failure.
Heart failure is a major health problem that is increasing inscope.1 Despite recent therapeutic advances, morbidity and mortalityafter the onset of heart failure remain substantial.1 Consequently,prevention of heart failure through identification and managementof risk factors and preclinical phases of the disease is a priority.2In this context, several studies have evaluated body-mass index(the weight in kilograms divided by the square of the heightin meters) as a risk factor for left ventricular remodelingand overt heart failure. In these investigations, obesity hasbeen consistently associated with left ventricular hypertrophyand dilatation,3,4,5,6 which are known precursors of heart failure.7,8Whereas extreme obesity has been associated with heart failure,9data are limited regarding the influence of overweight and lesserdegrees of obesity on the risk of heart failure.10,11,12 Accordingly,we investigated the relation of body-mass index with the riskof heart failure in a community-based sample.
Methods
Participants
The design and selection criteria of the Framingham Heart Studyhave been described previously.13,14 Participants in the 15thbiennial examination of the original cohort (1976 through 1979,2632 subjects) and the second offspring study examination (1979through 1983, 3863 subjects) were eligible for the present investigation.We excluded 614 attendees (9.5 percent) for the following reasons:age under 30 years (271 subjects), underweight (body-mass indexless than 18.5 [85 subjects]),15,16 heart failure at base-lineexamination (84 subjects), missing information on covariates(172 subjects), and lack of follow-up data (2 subjects). Afterthese exclusions, 5881 subjects (3177 women and 2704 men) remainedeligible. Written informed consent was obtained from the studyparticipants, and the research protocol was reviewed and approvedby the institutional review board of the Boston University Schoolof Medicine.
Estimation of Adiposity and Covariates
At each examination, a medical history was taken, a physicalexamination (including anthropometric measurements and measurementof blood pressure) was performed, a 12-lead electrocardiogramwas obtained, and risk factors for cardiovascular disease wereassessed. Height and weight were measured according to a standardizedprotocol. The body-mass index was calculated and was used asan estimate of overweight and obesity.16 The criteria and methodsof measurement of all covariates have been described previously.17
Outcome
Surveillance for the development of cardiovascular events wascontinuous for all participants. A panel of three experiencedphysicians reviewed suspected cardiovascular events by examininghospital records and information from outside physicians.17In this investigation, the primary outcome of interest was theoccurrence of a first episode of heart failure, as defined bythe Framingham Heart Study criteria.18 The simultaneous presenceof at least two major criteria or one major criterion in conjunctionwith two minor criteria was required to establish a diagnosisof heart failure. Major criteria included paroxysmal nocturnaldyspnea or orthopnea, jugular venous distention, pulmonary rales,radiographic cardiomegaly, acute pulmonary edema, a third heartsound, central venous pressure above 16 cm of water, hepatojugularreflux, and weight loss of at least 4.5 kg in five days in responseto treatment for heart failure. Minor criteria included bilateralankle edema, nocturnal cough, dyspnea on ordinary exertion,hepatomegaly, pleural effusion, and a heart rate of at least120 beats per minute. Minor criteria were acceptable only ifthey could not be attributed to another medical condition (suchas chronic lung disease, cirrhosis, ascites, or the nephroticsyndrome).
Statistical Analysis
We used Cox proportional-hazards regression models,19 stratifiedaccording to cohort (original or offspring), to examine therelation of body-mass index to the incidence of heart failure.We performed both sex-specific and sex-stratified analyses.Body-mass index was evaluated as both a continuous variable(with increases in risk calculated per increment of 1) and acategorical variable. Subjects with values of 18.5 to 24.9 wereclassified as normal (the reference group), those with valuesof 25.0 to 29.9 as overweight, and those with values of 30.0or more as obese.15,16 We adjusted for the following base-linecovariates: age, smoking status, alcohol consumption, totalserum cholesterol level, and presence or absence of valve disease,hypertension, diabetes mellitus, electrocardiographic left ventricularhypertrophy, and myocardial infarction (all defined at baseline). We constructed trend models to determine whether therewas a continuous gradient of heart-failure risk across categoriesof body-mass index. To evaluate the risk of heart failure associatedwith varying degrees of obesity, we performed analyses thatcategorized the obese group into three classes with body-massindexes of 30.0 to 34.9 (group 1), 35.0 to 39.9 (group 2), and40.0 or more (group 3).15,16 We also evaluated models withbody-mass index and all covariates treated as time-dependentvariables (updated every four years, including adjustment forthe occurrence of interim myocardial infarction).
Elevated body-mass index could predispose persons to heart failureby promoting atherogenic traits such as hypertension, diabetesmellitus, and dyslipidemia, which, in turn, could result inmyocardial infarction. Therefore, we constructed hierarchicalstatistical models using covariates defined at base line, withadjustment for potential confounders (age, cigarette smoking,alcohol consumption, and valve disease) and for all these variablesplus covariates that are known to be along the causal pathwayfrom excess weight to heart failure (e.g., hypertension, electrocardiographicleft ventricular hypertrophy, diabetes mellitus, high totalserum cholesterol level, and myocardial infarction). We alsoevaluated stepwise models with body-mass index, systolic bloodpressure, alcohol intake, and total serum cholesterol as continuousmeasures (other covariates were dichotomous).
We examined models incorporating interaction terms to evaluatevariation in the effect of body-mass index on the risk of heartfailure according to age, sex, smoking status, alcohol consumption,and the presence or absence of valve disease, hypertension,diabetes mellitus, and myocardial infarction (all defined atbase line).
We estimated the category-specific population attributable risk(PAR), expressed as a percentage, as a function of the proportionof cases occurring in a given category of body-mass index (pd)and the multivariable-adjusted relative risk (RR, equivalentto hazard ratios from models with covariates defined at baseline) with the following equation:20
PAR = pd [(RR – 1) / RR] x 100.
To obtain insight into the type of heart failure (systolic vs.diastolic) associated with increasing body-mass index, we reviewedechocardiographic reports for a subgroup of participants whounderwent evaluation of left ventricular systolic function within30 days after their first hospitalization for heart failurebetween 1989 and 1998. Heart failure was presumed to be dueto systolic dysfunction (systolic heart failure) if the estimatedleft ventricular ejection fraction was less than 50 percent,whereas a left ventricular ejection fraction of 50 percent ormore was considered to be consistent with diastolic heart failure.21The proportion of patients with heart failure who had a leftventricular ejection fraction under 40 percent, indicating moderateor severe left ventricular systolic dysfunction, was also examined.
Although underweight subjects were excluded from the primaryanalyses, we performed supplementary analyses comparing therisk of heart failure in these subjects with that in subjectswith a normal body-mass index.
A two-sided P value of less than 0.05 was considered to indicatestatistical significance. All analyses were performed with SASsoftware (version 6.12).22
Table 1. Base-Line Characteristics According to the Category of Body-Mass Index.
Body-Mass Index and the Risk of Heart Failure
During a mean follow-up of 14 years (maximum, 21.8), heart failuredeveloped in 496 participants (258 women and 238 men). The crudecumulative incidence (Figure 1) and the age-adjusted incidencerates (Table 2) of heart failure increased across categoriesof body-mass index for both men and women.
Figure 2. Risk of Heart Failure in Obese Subjects, According to Category of Body-Mass Index at the Base-Line Examination.
I bars represent the 95 percent confidence intervals for the hazard ratios. Hazard ratios were adjusted for age, total serum cholesterol level, cigarette smoking, alcohol consumption, and presence or absence of valve disease, hypertension, diabetes mellitus, electrocardiographic evidence of left ventricular hypertrophy, and myocardial infarction at base line. Normal weight (body-mass index, 18.5 to 24.9) was the reference category. Hazard ratios on the y axis are shown on a logarithmic scale. Data for men in obesity class 3 are not provided because of the small sample (eight subjects).
In models adjusted only for age, smoking status, alcohol consumption,and valve disease, the hazard ratios for heart failure per increaseof 1 in the body-mass index were 1.08 (95 percent confidenceinterval, 1.06 to 1.11) in women and 1.07 (95 percent confidenceinterval, 1.04 to 1.11) in men. In these models, in comparisonwith subjects with a normal body-mass index, the hazard ratiosfor heart failure were 1.53 (95 percent confidence interval,1.15 to 2.04) for overweight women, 2.24 (95 percent confidenceinterval, 1.62 to 3.11) for obese women, 1.35 (95 percent confidenceinterval, 0.99 to 1.85) for overweight men, and 2.34 (95 percentconfidence interval, 1.60 to 3.41) for obese men. Additionaladjustment for hypertension, diabetes mellitus, high total serumcholesterol level, electrocardiographic left ventricular hypertrophy,and myocardial infarction (variables along the causal pathway)led to a slight attenuation of the hazard ratios in men butnot in women (Table 3, models IA and IB). In models with stepwiseselection of covariates (at an alpha level of <0.05), age,myocardial infarction, valve disease, and systolic blood pressureentered ahead of body-mass index. The hazard ratio for heartfailure associated with body-mass index was nearly identicalto that shown in model IA in Table 3.
Effect Modification
The effect of body-mass index on the risk of heart failure didnot vary with age, sex, smoking status, alcohol consumption,or the presence or absence of valve disease or diabetes mellitus(P>0.10). However, we noted effect modification with hypertension(P=0.03) and myocardial-infarction status (P=0.02). The hazardratio for the trend in the risk of heart failure across body-massindex categories was lower in subjects with hypertension (1.30;95 percent confidence interval, 1.11 to 1.52) than in subjectswithout hypertension (1.66; 95 percent confidence interval,1.33 to 2.07). Increased body-mass index was not associatedwith an increased risk of heart failure in those with myocardialinfarction at base line (148 subjects; hazard ratio for trendacross categories, 0.80; 95 percent confidence interval, 0.50to 1.30) as compared with those without myocardial infarction(5733 subjects; hazard ratio, 1.50; 95 percent confidence interval,1.31 to 1.71). The statistical power to detect hazard ratiosof 1.5, 2.0, and 2.5 for heart failure (for trend across body-massindex categories at an alpha level of <0.05) in subjectswith myocardial infarction at base line was 0.38, 0.81, and0.96, respectively.
Population Attributable Risk
The population attributable risk of heart failure due to overweightwas 14.0 percent in women and 8.8 percent in men. The correspondingpopulation attributable risks due to obesity were 13.9 percentin women and 10.9 percent in men.
Echocardiographic Evaluation
Of the 120 participants who underwent echocardiographic evaluationwithin 30 days of their first hospitalization for heart failure(24 percent of those with heart failure), 75 percent (21 of28) of those with a normal body-mass index, 65 percent (37 of57) of overweight subjects, and 66 percent (23 of 35) of obesesubjects had a left ventricular ejection fraction of less than50 percent (indicative of systolic heart failure). The proportionsof subjects with heart failure who had a left ventricular ejectionfraction of less than 40 percent in the normal, overweight,and obese groups were 53.6 percent, 52.6 percent, and 42.9 percent,respectively.
Risk of Heart Failure in Underweight Subjects
Only 3 of the 76 underweight subjects (64 women and 12 men)had heart failure on follow-up. In sex-stratified models, underweightsubjects had a multivariable-adjusted hazard ratio of 0.95 (95percent confidence interval, 0.37 to 2.45) as compared withthose with a normal body-mass index.
The smaller effect of body-mass index on the risk of heart failurein subjects with hypertension probably indicates a decreasedcontribution of obesity to the risk of heart failure in thepresence of this major risk factor. The lack of effect of body-massindex on the risk of heart failure in subjects with myocardialinfarction, however, must be interpreted with caution becauseof the small sample. In a subgroup of subjects who underwentechocardiographic evaluation within 30 days after their firsthospitalization for heart failure, obesity was associated withboth systolic and diastolic heart failure.
Three prior community-based studies reported an associationof increased body-mass index with an increased risk of heartfailure.10,11,12 However, they did not use the contemporarybody-mass index classification,15,16 and ascertainment of heartfailure was based primarily on hospital-discharge codes or deathcertificates. Furthermore, none of these studies assessed theentire range of body-mass index values or modeled covariatesas time-dependent variables. Only one study10 adjusted for theoccurrence of an interim myocardial infarction.
Other investigators have reported that a low body-mass indexis associated with increased mortality among patients with heartfailure.23,24 Our study had limited power to evaluate the riskof heart failure in underweight subjects. In this context, itis important to draw a distinction between the role of elevatedbody-mass index as a risk factor for heart failure and its effecton survival after the onset of heart failure.
The strength of the association, the stepwise increase in therisk of heart failure across increasing categories of body-massindex, the demonstration of a temporal sequence (with increasedbody-mass index preceding the development of heart failure),and the consistency of results in multiple analyses suggesta causal relation between increased body-mass index and heartfailure. There are several plausible mechanisms for such anassociation. Increased body-mass index is a risk factor forhypertension,25 diabetes mellitus,26,27 and dyslipidemia,16all of which augment the risk of myocardial infarction,28,29an important antecedent of heart failure.10,11,12,30 In addition,hypertension and diabetes mellitus independently increase therisk of heart failure.10,11,12,30,31 Elevated body-mass indexis associated with altered left ventricular remodeling,3,4,5,6,8possibly owing to increased hemodynamic load,32,33 neurohormonalactivation,34 and increased oxidative stress.35 Recently, Zhouet al. raised the possibility of a direct effect of obesityon the myocardium by demonstrating cardiac steatosis and lipoapoptosisin an animal model of obesity.36
The strengths of our investigation include the large community-basedsample, standardized assessment of body-mass index, consistentuse of the same diagnostic criteria for heart failure, and thelong period of follow-up. Nonetheless, it is important to acknowledgeseveral limitations. Although a diagnosis of heart failure wasmade only after a careful review of the records by a panel ofthree physicians, it is still possible that symptoms (such asdyspnea) and signs (such as ankle edema) may be misconstruedas indicating heart failure more often in obese persons.37 Pedaledema was more common among obese subjects with heart failure,but the distributions of major and all other minor heart-failurecriteria were similar among subjects with heart failure in thethree categories of body-mass index (data not shown). Exclusionof pedal edema as a minor criterion in the obese subjects didnot alter the diagnosis of heart failure by the Framingham HeartStudy adjudication panel in any instance. Other evidence againstmisclassification of subjects with heart failure as the explanationfor the observed association includes the substantial increasein the risk of heart failure among those who were overweightand those with lesser degrees of obesity, and the finding ina subgroup analysis that 43 percent of obese subjects with heartfailure had moderately or severely impaired left ventricularsystolic function. Finally, because our sample was predominantlywhite, we avoided confounding by race but at the same time,we reduced the generalizability of our findings to other racesand ethnic groups.
Our findings suggest that obesity is an important risk factorfor heart failure in both women and men. Approximately 11 percentof cases of heart failure among men and 14 percent among womenin the community are attributable to obesity alone. The contributionof obesity to the risk of heart failure has not been adequatelyrecognized, and our observational data suggest that effortsto promote optimal body weight may reduce the risk of heartfailure. Our results are particularly relevant given the alarmingtrend toward increasing obesity in the United States.16
Supported in part by a contract (N01-HC-25195) with the NationalHeart, Lung, and Blood Institute; by grants from Roche Laboratories(to Dr. Wilson) and Servier Amérique (to Dr. Kannel);and by a Research Career Award (1K24 HL04334) from the NationalHeart, Lung, and Blood Institute (to Dr. Vasan).
Source Information
From the Framingham Heart Study, Framingham, Mass. (S.K., J.C.E., D.L., P.W.F.W., E.J.B., M.G.L., W.B.K., R.S.V.); the Section of Preventive Medicine (D.L., E.J.B., M.G.L., W.B.K., R.S.V.) and the Cardiology Section (E.J.B., R.S.V.), Boston University School of Medicine, Boston; the Cardiology Division, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston (D.L.); and the National Heart, Lung, and Blood Institute, Bethesda, Md. (D.L.).
Address reprint requests to Dr. Vasan at the Framingham Heart Study, 73 Mt. Wayte Ave., Suite 2, Framingham, MA 01702, or at vasan{at}fram.nhlbi.nih.gov.
References
American Heart Association. 2002 Heart and stroke statistical update. Dallas: American Heart Association, 2001.
Hunt SA, Baker DW, Chin MH, et al. ACC/AHA guidelines for the evaluation and management of chronic heart failure in the adult: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Revise the 1995 Guidelines for the Evaluation and Management of Heart Failure). J Am Coll Cardiol 2001;38:2101-2113. [Free Full Text]
Messerli FH, Sundgaard-Riise K, Reisin ED, et al. Dimorphic cardiac adaptation to obesity and arterial hypertension. Ann Intern Med 1983;99:757-761. [Free Full Text]
Hammond IW, Devereux RB, Alderman MH, Laragh JH. Relation of blood pressure and body build to left ventricular mass in normotensive and hypertensive employed adults. J Am Coll Cardiol 1988;12:996-1004. [Abstract]
Lauer MS, Anderson KM, Kannel WB, Levy D. The impact of obesity on left ventricular mass and geometry: the Framingham Heart Study. JAMA 1991;266:231-236. [Free Full Text]
Alpert MA, Lambert CR, Terry BE, et al. Influence of left ventricular mass on left ventricular diastolic filling in normotensive morbid obesity. Am Heart J 1995;130:1068-1073. [CrossRef][Web of Science][Medline]
Vasan RS, Larson MG, Benjamin EJ, Evans JC, Levy D. Left ventricular dilatation and the risk of congestive heart failure in people without myocardial infarction. N Engl J Med 1997;336:1350-1355. [Free Full Text]
Gardin JM, McClelland R, Kitzman D, et al. M-mode echocardiographic predictors of six- to seven-year incidence of coronary heart disease, stroke, congestive heart failure, and mortality in an elderly cohort (the Cardiovascular Health Study). Am J Cardiol 2001;87:1051-1057. [CrossRef][Web of Science][Medline]
Alpert MA. Obesity cardiomyopathy: pathophysiology and evolution of the clinical syndrome. Am J Med Sci 2001;321:225-236. [CrossRef][Web of Science][Medline]
Chen YT, Vaccarino V, Williams CS, Butler J, Berkman LF, Krumholz HM. Risk factors for heart failure in the elderly: a prospective community-based study. Am J Med 1999;106:605-612. [CrossRef][Web of Science][Medline]
He J, Ogden LG, Bazzano LA, Vupputuri S, Loria C, Whelton PK. Risk factors for congestive heart failure in US men and women: NHANES I epidemiologic follow-up study. Arch Intern Med 2001;161:996-1002. [Free Full Text]
Wilhelmsen L, Rosengren A, Eriksson H, Lappas G. Heart failure in the general population of men -- morbidity, risk factors, and prognosis. J Intern Med 2001;249:253-261. [CrossRef][Web of Science][Medline]
Dawber TR, Meadors GF, Moore FE Jr. Epidemiological approaches to heart disease: the Framingham Study. Am J Public Health 1951;41:279-286. [Free Full Text]
Kannel WB, Feinleib M, McNamara PM, Garrison RJ, Castelli WP. An investigation of coronary heart disease in families: the Framingham Offspring Study. Am J Epidemiol 1979;110:281-290. [Free Full Text]
Obesity: preventing and managing the global epidemic: report of a WHO consultation. World Health Organ Tech Rep Ser 2000;894:1-253.
Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults. Bethesda, Md.: National Heart, Lung, and Blood Institute, 1998. (NIH publication no. 98-4083.)
Kannel WB, Wolf PA, Garrison RJ, eds. The Framingham Study: an epidemiological investigation of cardiovascular disease. Section 34. Some risk factors related to the annual incidence of cardiovascular disease and death using pooled repeated biennial measurements: Framingham Heart Study, 30-year follow-up. Bethesda, Md.: National Heart, Lung, and Blood Institute, 1987. (NIH publication no. 87-2703.)
McKee PA, Castelli WP, McNamara PM, Kannel WB. The natural history of congestive heart failure: the Framingham Study. N Engl J Med 1971;285:1441-1446. [Web of Science][Medline]
Cox DR. Regression models and life-tables. J R Stat Soc [B] 1972;34:187-220.
Rockhill B, Newman B, Weinberg C. Use and misuse of population attributable fractions. Am J Public Health 1998;88:15-19. [Free Full Text]
Vasan RS, Levy D. Defining diastolic heart failure: a call for standardized diagnostic criteria. Circulation 2000;101:2118-2121. [Free Full Text]
SAS/STAT software: PHREG procedure: changes and enhancements through release 6.12. Cary, N.C.: SAS Institute, 1997:871-948.
Anker SD, Rauchhaus M. Insights into the pathogenesis of chronic heart failure: immune activation and cachexia. Curr Opin Cardiol 1999;14:211-216. [CrossRef][Web of Science][Medline]
Mosterd A, Cost B, Hoes AW, et al. The prognosis of heart failure in the general population: the Rotterdam Study. Eur Heart J 2001;22:1318-1327. [Free Full Text]
Stamler J. Epidemiologic findings on body mass and blood pressure in adults. Ann Epidemiol 1991;1:347-362. [Medline]
Chan JM, Rimm EB, Colditz GA, Stampfer MJ, Willett WC. Obesity, fat distribution, and weight gain as risk factors for clinical diabetes in men. Diabetes Care 1994;17:961-969. [Abstract]
Colditz GA, Willett WC, Rotnitzky A, Manson JE. Weight gain as a risk factor for clinical diabetes mellitus in women. Ann Intern Med 1995;122:481-486. [Free Full Text]
Kannel WB, McGee DL. Diabetes and glucose tolerance as risk factors for cardiovascular disease: the Framingham Study. Diabetes Care 1979;2:120-126. [Abstract]
Manson JE, Colditz GA, Stampfer MJ, et al. A prospective study of obesity and risk of coronary heart disease in women. N Engl J Med 1990;322:882-889. [Abstract]
Kannel WB, D'Agostino RB, Silbershatz H, Belanger AJ, Wilson PW, Levy D. Profile for estimating risk of heart failure. Arch Intern Med 1999;159:1197-1204. [Free Full Text]
Levy D, Larson MG, Vasan RS, Kannel WB, Ho KK. The progression from hypertension to congestive heart failure. JAMA 1996;275:1557-1562. [Free Full Text]
Alexander JK, Dennis EW, Smith WG, Amad KH, Duncan WC, Austin RC. Blood volume, cardiac output, and distribution of systemic blood flow in extreme obesity. Cardiovasc Res Cent Bull 1963;1:39-44. [Medline]
Messerli FH, Sundgaard-Riise K, Reisin E, Dreslinski G, Dunn FG, Frohlich E. Disparate cardiovascular effects of obesity and arterial hypertension. Am J Med 1983;74:808-812. [CrossRef][Web of Science][Medline]
Engeli S, Sharma AM. The renin-angiotensin system and natriuretic peptides in obesity-associated hypertension. J Mol Med 2001;79:21-29. [CrossRef][Web of Science][Medline]
Vincent HK, Powers SK, Stewart DJ, Shanely RA, Demirel H, Naito H. Obesity is associated with increased myocardial oxidative stress. Int J Obes Relat Metab Disord 1999;23:67-74. [CrossRef][Web of Science][Medline]
Zhou YT, Grayburn P, Karim A, et al. Lipotoxic heart disease in obese rats: implications for human obesity. Proc Natl Acad Sci U S A 2000;97:1784-1789. [Free Full Text]
Caruana L, Petrie MC, Davie AP, McMurray JJ. Do patients with suspected heart failure and preserved left ventricular systolic function suffer from "diastolic heart failure" or from misdiagnosis? A prospective descriptive study. BMJ 2000;321:215-218. [Free Full Text]
Obesity and the Risk of Heart Failure
O'Brien G., Maurer M. S., Taegtmeyer H., Wilson C. R., Dart R. A., Jenny-Avital E. R., Kenchaiah S., Levy D., Vasan R. S., Massie B. M.
Extract |
Full Text |
PDF
N Engl J Med 2002;
347:1887-1889, Dec 5, 2002.
Correspondence
This article has been cited by other articles:
Frankenstein, L., Zugck, C., Nelles, M., Schellberg, D., Katus, H. A., Remppis, B. A.
(2009). The obesity paradox in stable chronic heart failure does not persist after matching for indicators of disease severity and confounders. Eur J Heart Fail
11: 1189-1194
[Abstract][Full Text]
Majane, O. H.I., Vengethasamy, L., du Toit, E. F., Makaula, S., Woodiwiss, A. J., Norton, G. R.
(2009). Dietary-Induced Obesity Hastens the Progression From Concentric Cardiac Hypertrophy to Pump Dysfunction in Spontaneously Hypertensive Rats. Hypertension
54: 1376-1383
[Abstract][Full Text]
Stanley, W. C., Shah, K. B., Essop, M. F.
(2009). Does Junk Food Lead to Heart Failure?: Importance of Dietary Macronutrient Composition in Hypertension. Hypertension
54: 1209-1210
[Full Text]
Oreopoulos, A., McAlister, F. A., Kalantar-Zadeh, K., Padwal, R., Ezekowitz, J. A., Sharma, A. M., Kovesdy, C. P., Fonarow, G. C., Norris, C. M.
(2009). The relationship between body mass index, treatment, and mortality in patients with established coronary artery disease: a report from APPROACH. Eur Heart J
30: 2584-2592
[Abstract][Full Text]
Guder, G., Frantz, S., Bauersachs, J., Allolio, B., Wanner, C., Koller, M. T., Ertl, G., Angermann, C. E., Stork, S.
(2009). Reverse Epidemiology in Systolic and Nonsystolic Heart Failure: Cumulative Prognostic Benefit of Classical Cardiovascular Risk Factors. Circ Heart Fail
2: 563-571
[Abstract][Full Text]
Takaoka, M., Nagata, D., Kihara, S., Shimomura, I., Kimura, Y., Tabata, Y., Saito, Y., Nagai, R., Sata, M.
(2009). Periadventitial Adipose Tissue Plays a Critical Role in Vascular Remodeling. Circ. Res.
105: 906-911
[Abstract][Full Text]
Tolpin, D. A., Collard, C. D., Lee, V.-V., Elayda, M. A., Pan, W.
(2009). Obesity is associated with increased morbidity after coronary artery bypass graft surgery in patients with renal insufficiency. J. Thorac. Cardiovasc. Surg.
138: 873-879
[Abstract][Full Text]
Pellicano, R., Strauss, B. J., Polkinghorne, K. R., Kerr, P. G.
(2009). Body composition in home haemodialysis versus conventional haemodialysis: a cross-sectional, matched, comparative study. Nephrol Dial Transplant
0: gfp490v1-gfp490
[Abstract][Full Text]
Chirinos, J. A., Rietzschel, E. R., De Buyzere, M. L., De Bacquer, D., Gillebert, T. C., Gupta, A. K., Segers, P., on behalf of the Asklepios investigators,
(2009). Arterial Load and Ventricular-Arterial Coupling: Physiologic Relations With Body Size and Effect of Obesity. Hypertension
54: 558-566
[Abstract][Full Text]
Mousseaux, E.
(2009). Obesity and cardiovascular disease: how can cardiac magnetic resonance help?. J Am Coll Cardiol
54: 727-729
[Full Text]
Lamounier-Zepter, V., Look, C., Alvarez, J., Christ, T., Ravens, U., Schunck, W.-H., Ehrhart-Bornstein, M., Bornstein, S. R., Morano, I.
(2009). Adipocyte Fatty Acid-Binding Protein Suppresses Cardiomyocyte Contraction: A New Link Between Obesity and Heart Disease. Circ. Res.
105: 326-334
[Abstract][Full Text]
Denk, K., Albers, J., Kayhan, N., Ister, D., Bonz, A., Werner, C., Munzel, T., Vahl, C.-F.
(2009). Evidence for a negative inotropic effect of obesity in human myocardium?. Eur. J. Cardiothorac. Surg.
36: 300-305
[Abstract][Full Text]
Roberts, A. W., Clark, A. L., Witte, K. K.
(2009). Review article: Left ventricular dysfunction and heart failure in metabolic syndrome and diabetes without overt coronary artery disease -- do we need to screen our patients?. Diabetes and Vascular Disease Research
6: 153-163
[Abstract]
Tavakol, M. M., Vincenti, F. G., Assadi, H., Frederick, M. J., Tomlanovich, S. J., Roberts, J. P., Posselt, A. M.
(2009). Long-Term Renal Function and Cardiovascular Disease Risk in Obese Kidney Donors. CJASN
4: 1230-1238
[Abstract][Full Text]
Bohm, S. H., Thamm, O. C., von Sandersleben, A., Bangert, K., Langwieler, T. E., Tusman, G., Strate, T. G., Standl, T. G.
(2009). Alveolar Recruitment Strategy and High Positive End-Expiratory Pressure Levels Do Not Affect Hemodynamics in Morbidly Obese Intravascular Volume-Loaded Patients. Anesth. Analg.
109: 160-163
[Abstract][Full Text]
Tsukamoto, O., Fujita, M., Kato, M., Yamazaki, S., Asano, Y., Ogai, A., Okazaki, H., Asai, M., Nagamachi, Y., Maeda, N., Shintani, Y., Minamino, T., Asakura, M., Kishimoto, I., Funahashi, T., Tomoike, H., Kitakaze, M.
(2009). Natriuretic peptides enhance the production of adiponectin in human adipocytes and in patients with chronic heart failure.. J Am Coll Cardiol
53: 2070-2077
[Abstract][Full Text]
Lavie, C. J., Milani, R. V., Ventura, H. O.
(2009). Obesity and cardiovascular disease: risk factor, paradox, and impact of weight loss.. J Am Coll Cardiol
53: 1925-1932
[Abstract][Full Text]
Levitan, E. B., Yang, A. Z., Wolk, A., Mittleman, M. A.
(2009). Adiposity and Incidence of Heart Failure Hospitalization and Mortality: A Population-Based Prospective Study. Circ Heart Fail
2: 202-208
[Abstract][Full Text]
Whalley, G. A., Gusso, S., Hofman, P., Cutfield, W., Poppe, K. K., Doughty, R. N., Baldi, J. C.
(2009). Structural and Functional Cardiac Abnormalities in Adolescent Girls with Poorly Controlled Type 2 Diabetes. Diabetes Care
32: 883-888
[Abstract][Full Text]
Hunt, S. A., Abraham, W. T., Chin, M. H., Feldman, A. M., Francis, G. S., Ganiats, T. G., Jessup, M., Konstam, M. A., Mancini, D. M., Michl, K., Oates, J. A., Rahko, P. S., Silver, M. A., Stevenson, L. W., Yancy, C. W.
(2009). 2009 Focused Update Incorporated Into the ACC/AHA 2005 Guidelines for the Diagnosis and Management of Heart Failure in Adults: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines Developed in Collaboration With the International Society for Heart and Lung Transplantation. J Am Coll Cardiol
53: e1-e90
[Full Text]
2005 WRITING COMMITTEE MEMBERS, , Hunt, S. A., Abraham, W. T., Chin, M. H., Feldman, A. M., Francis, G. S., Ganiats, T. G., Jessup, M., Konstam, M. A., Mancini, D. M., Michl, K., Oates, J. A., Rahko, P. S., Silver, M. A., Stevenson, L. W., Yancy, C. W.
(2009). 2009 Focused Update Incorporated Into the ACC/AHA 2005 Guidelines for the Diagnosis and Management of Heart Failure in Adults: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: Developed in Collaboration With the International Society for Heart and Lung Transplantation. Circulation
119: e391-e479
[Full Text]
Vivo, R. P., Krim, S. R., Cevik, C., Witteles, R. M.
(2009). Heart failure in hispanics.. J Am Coll Cardiol
53: 1167-1175
[Abstract][Full Text]
Lieb, W., Sullivan, L. M., Harris, T. B., Roubenoff, R., Benjamin, E. J., Levy, D., Fox, C. S., Wang, T. J., Wilson, P. W., Kannel, W. B., Vasan, R. S.
(2009). Plasma Leptin Levels and Incidence of Heart Failure, Cardiovascular Disease, and Total Mortality in Elderly Individuals. Diabetes Care
32: 612-616
[Abstract][Full Text]
Bibbins-Domingo, K., Pletcher, M. J., Lin, F., Vittinghoff, E., Gardin, J. M., Arynchyn, A., Lewis, C. E., Williams, O. D., Hulley, S. B.
(2009). Racial Differences in Incident Heart Failure among Young Adults. NEJM
360: 1179-1190
[Abstract][Full Text]
Frankel, D. S., Vasan, R. S., D'Agostino, R. B. Sr, Benjamin, E. J., Levy, D., Wang, T. J., Meigs, J. B.
(2009). Resistin, Adiponectin, and Risk of Heart Failure: The Framingham Offspring Study. J Am Coll Cardiol
53: 754-762
[Abstract][Full Text]
Dunn, S. P., Bleske, B., Dorsch, M., Macaulay, T., Van Tassell, B., Vardeny, O.
(2009). Nutrition and Heart Failure: Impact of Drug Therapies and Management Strategies. Nutr Clin Pract
24: 60-75
[Abstract][Full Text]
Kenchaiah, S., Sesso, H. D., Gaziano, J. M.
(2009). Body Mass Index and Vigorous Physical Activity and the Risk of Heart Failure Among Men. Circulation
119: 44-52
[Abstract][Full Text]
Folsom, A. R., Yamagishi, K., Hozawa, A., Chambless, L. E., for the Atherosclerosis Risk in Communities Study,
(2009). Absolute and Attributable Risks of Heart Failure Incidence in Relation to Optimal Risk Factors. Circ Heart Fail
2: 11-17
[Abstract][Full Text]
Loehr, L. R., Rosamond, W. D., Poole, C., Marie McNeill, A., Chang, P. P., Folsom, A. R., Chambless, L. E., Heiss, G.
(2009). Association of Multiple Anthropometrics of Overweight and Obesity With Incident Heart Failure: The Atherosclerosis Risk in Communities Study. Circ Heart Fail
2: 18-24
[Abstract][Full Text]
Ashrafian, H., le Roux, C. W., Darzi, A., Athanasiou, T.
(2008). Effects of Bariatric Surgery on Cardiovascular Function. Circulation
118: 2091-2102
[Full Text]
Mathew, B., Francis, L., Kayalar, A., Cone, J.
(2008). Obesity: Effects on Cardiovascular Disease and its Diagnosis. J Am Board Fam Med
21: 562-568
[Abstract][Full Text]
Frankenstein, L., Remppis, A., Nelles, M., Schaelling, B., Schellberg, D., Katus, H., Zugck, C.
(2008). Relation of N-terminal pro-brain natriuretic peptide levels and their prognostic power in chronic stable heart failure to obesity status. Eur Heart J
29: 2634-2640
[Abstract][Full Text]
Bahrami, H., Kronmal, R., Bluemke, D. A., Olson, J., Shea, S., Liu, K., Burke, G. L., Lima, J. A. C.
(2008). Differences in the Incidence of Congestive Heart Failure by Ethnicity: The Multi-Ethnic Study of Atherosclerosis. Arch Intern Med
168: 2138-2145
[Abstract][Full Text]
Kosmala, W., O'Moore-Sullivan, T. M., Plaksej, R., Kuliczkowska-Plaksej, J., Przewlocka-Kosmala, M., Marwick, T. H.
(2008). Subclinical Impairment of Left Ventricular Function in Young Obese Women: Contributions of Polycystic Ovary Disease and Insulin Resistance. J. Clin. Endocrinol. Metab.
93: 3748-3754
[Abstract][Full Text]
Somers, V. K., White, D. P., Amin, R., Abraham, W. T., Costa, F., Culebras, A., Daniels, S., Floras, J. S., Hunt, C. E., Olson, L. J., Pickering, T. G., Russell, R., Woo, M., Young, T.
(2008). Sleep Apnea and Cardiovascular Disease: An American Heart Association/American College of Cardiology Foundation Scientific Statement From the American Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology, Stroke Council, and Council on Cardiovascular Nursing In Collaboration With the National Heart, Lung, and Blood Institute National Center on Sleep Disorders Research (National Institutes of Health). Circulation
118: 1080-1111
[Full Text]
Yamamoto, E., Dong, Y.-F., Kataoka, K., Yamashita, T., Tokutomi, Y., Matsuba, S., Ichijo, H., Ogawa, H., Kim-Mitsuyama, S.
(2008). Olmesartan Prevents Cardiovascular Injury and Hepatic Steatosis in Obesity and Diabetes, Accompanied by Apoptosis Signal Regulating Kinase-1 Inhibition. Hypertension
52: 573-580
[Abstract][Full Text]
Somers, V. K., White, D. P., Amin, R., Abraham, W. T., Costa, F., Culebras, A., Daniels, S., Floras, J. S., Hunt, C. E., Olson, L. J., Pickering, T. G., Russell, R., Woo, M., Young, T.
(2008). Sleep Apnea and Cardiovascular Disease: An American Heart Association/American College of Cardiology Foundation Scientific Statement From the American Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology, Stroke Council, and Council on Cardiovascular Nursing In Collaboration With the National Heart, Lung, and Blood Institute National Center on Sleep Disorders Research (National Institutes of Health). J Am Coll Cardiol
52: 686-717
[Full Text]
Mafra, D., Guebre-Egziabher, F., Fouque, D.
(2008). Body mass index, muscle and fat in chronic kidney disease: questions about survival. Nephrol Dial Transplant
23: 2461-2466
[Abstract][Full Text]
Harmancey, R., Wilson, C. R., Taegtmeyer, H.
(2008). Adaptation and Maladaptation of the Heart in Obesity. Hypertension
52: 181-187
[Full Text]
Kumanyika, S. K., Obarzanek, E., Stettler, N., Bell, R., Field, A. E., Fortmann, S. P., Franklin, B. A., Gillman, M. W., Lewis, C. E., Poston, W. C. II, Stevens, J., Hong, Y.
(2008). Population-Based Prevention of Obesity: The Need for Comprehensive Promotion of Healthful Eating, Physical Activity, and Energy Balance: A Scientific Statement From American Heart Association Council on Epidemiology and Prevention, Interdisciplinary Committee for Prevention (Formerly the Expert Panel on Population and Prevention Science). Circulation
118: 428-464
[Abstract][Full Text]
Karmazyn, M., Purdham, D. M., Rajapurohitam, V., Zeidan, A.
(2008). Signalling mechanisms underlying the metabolic and other effects of adipokines on the heart. Cardiovasc Res
79: 279-286
[Abstract][Full Text]
Hershman, D. L., McBride, R. B., Eisenberger, A., Tsai, W. Y., Grann, V. R., Jacobson, J. S.
(2008). Doxorubicin, Cardiac Risk Factors, and Cardiac Toxicity in Elderly Patients With Diffuse B-Cell Non-Hodgkin's Lymphoma. JCO
26: 3159-3165
[Abstract][Full Text]
Peterson, L. R., Soto, P. F., Herrero, P., Mohammed, B. S., Avidan, M. S., Schechtman, K. B., Dence, C., Gropler, R. J.
(2008). Impact of Gender on the Myocardial Metabolic Response to Obesity.. J Am Coll Cardiol Img
1: 424-433
[Abstract][Full Text]
Taegtmeyer, H., Algahim, M. F.
(2008). Obesity and cardiac metabolism in women.. J Am Coll Cardiol Img
1: 434-435
[Full Text]
Weisberg, S. P., Leibel, R., Tortoriello, D. V.
(2008). Dietary Curcumin Significantly Improves Obesity-Associated Inflammation and Diabetes in Mouse Models of Diabesity. Endocrinology
149: 3549-3558
[Abstract][Full Text]
Tominaga, H., Katoh, H., Odagiri, K., Takeuchi, Y., Kawashima, H., Saotome, M., Urushida, T., Satoh, H., Hayashi, H.
(2008). Different effects of palmitoyl-L-carnitine and palmitoyl-CoA on mitochondrial function in rat ventricular myocytes. Am. J. Physiol. Heart Circ. Physiol.
295: H105-H112
[Abstract][Full Text]
Aubin, M.-C., Lajoie, C., Clement, R., Gosselin, H., Calderone, A., Perrault, L. P.
(2008). Female Rats Fed a High-Fat Diet Were Associated with Vascular Dysfunction and Cardiac Fibrosis in the Absence of Overt Obesity and Hyperlipidemia: Therapeutic Potential of Resveratrol. J. Pharmacol. Exp. Ther.
325: 961-968
[Abstract][Full Text]
Cha, Y.-M., Friedman, P. A., Asirvatham, S. J., Shen, W.-K., Munger, T. M., Rea, R. F., Brady, P. A., Jahangir, A., Monahan, K. H., Hodge, D. O., Meverden, R. A., Gersh, B. J., Hammill, S. C., Packer, D. L.
(2008). Catheter Ablation for Atrial Fibrillation in Patients With Obesity. Circulation
117: 2583-2590
[Abstract][Full Text]
Schocken, D. D., Benjamin, E. J., Fonarow, G. C., Krumholz, H. M., Levy, D., Mensah, G. A., Narula, J., Shor, E. S., Young, J. B., Hong, Y.
(2008). Prevention of Heart Failure: A Scientific Statement From the American Heart Association Councils on Epidemiology and Prevention, Clinical Cardiology, Cardiovascular Nursing, and High Blood Pressure Research; Quality of Care and Outcomes Research Interdisciplinary Working Group; and Functional Genomics and Translational Biology Interdisciplinary Working Group. Circulation
117: 2544-2565
[Abstract][Full Text]
Bahrami, H., Bluemke, D. A., Kronmal, R., Bertoni, A. G., Lloyd-Jones, D. M., Shahar, E., Szklo, M., Lima, J. A.C.
(2008). Novel Metabolic Risk Factors for Incident Heart Failure and Their Relationship With Obesity: The MESA (Multi-Ethnic Study of Atherosclerosis) Study. J Am Coll Cardiol
51: 1775-1783
[Abstract][Full Text]
Abel, E. D., Litwin, S. E., Sweeney, G.
(2008). Cardiac Remodeling in Obesity. Physiol. Rev.
88: 389-419
[Abstract][Full Text]
Tanaka, T., Tsutamoto, T., Sakai, H., Nishiyama, K., Fujii, M., Yamamoto, T., Horie, M.
(2008). Effect of atrial natriuretic peptide on adiponectin in patients with heart failure. Eur J Heart Fail
10: 360-366
[Abstract][Full Text]
Lopez-Jimenez, F., Sert Kuniyoshi, F. H., Gami, A., Somers, V. K.
(2008). Obstructive Sleep Apnea: Implications for Cardiac and Vascular Disease. Chest
133: 793-804
[Full Text]
Golbin, J. M., Somers, V. K., Caples, S. M.
(2008). Obstructive Sleep Apnea, Cardiovascular Disease, and Pulmonary Hypertension. Proc Am Thorac Soc
5: 200-206
[Abstract][Full Text]
Buettner, H. J., Mueller, C.
(2007). Effects of obesity on mortality in patients with unstable angina or non-ST-elevation myocardial infarction: reply. Eur Heart J
28: 2950-2951
[Full Text]
Lee, D. S., Massaro, J. M., Wang, T. J., Kannel, W. B., Benjamin, E. J., Kenchaiah, S., Levy, D., D'Agostino, R. B. Sr, Vasan, R. S.
(2007). Antecedent Blood Pressure, Body Mass Index, and the Risk of Incident Heart Failure in Later Life. Hypertension
50: 869-876
[Abstract][Full Text]
Szczepaniak, L. S., Victor, R. G., Orci, L., Unger, R. H.
(2007). Forgotten but Not Gone: The Rediscovery of Fatty Heart, the Most Common Unrecognized Disease in America. Circ. Res.
101: 759-767
[Abstract][Full Text]
Whaley-Connell, A., Pavey, B. S., Chaudhary, K., Saab, G., Sowers, J. R.
(2007). Review: Renin-angiotensin-aldosterone system intervention in the cardiometabolic syndrome and cardio-renal protection. Ther Adv Cardiovasc Dis
1: 27-35
[Abstract]
Gundewar, S., Calvert, J. W., Elrod, J. W., Lefer, D. J.
(2007). Cytoprotective effects of N,N,N-trimethylsphingosine during ischemia- reperfusion injury are lost in the setting of obesity and diabetes. Am. J. Physiol. Heart Circ. Physiol.
293: H2462-H2471
[Abstract][Full Text]
Echahidi, N., Mohty, D., Pibarot, P., Despres, J.-P., O'Hara, G., Champagne, J., Philippon, F., Daleau, P., Voisine, P., Mathieu, P.
(2007). Obesity and Metabolic Syndrome Are Independent Risk Factors for Atrial Fibrillation After Coronary Artery Bypass Graft Surgery. Circulation
116: I-213-I-219
[Abstract][Full Text]
Gomez-Ambrosi, J., Catalan, V., Ramirez, B., Rodriguez, A., Colina, I., Silva, C., Rotellar, F., Mugueta, C., Gil, M. J., Cienfuegos, J. A., Salvador, J., Fruhbeck, G.
(2007). Plasma Osteopontin Levels and Expression in Adipose Tissue Are Increased in Obesity. J. Clin. Endocrinol. Metab.
92: 3719-3727
[Abstract][Full Text]
Pinder, M. C., Duan, Z., Goodwin, J. S., Hortobagyi, G. N., Giordano, S. H.
(2007). Congestive Heart Failure in Older Women Treated With Adjuvant Anthracycline Chemotherapy for Breast Cancer. JCO
25: 3808-3815
[Abstract][Full Text]
See, R., Abdullah, S. M., McGuire, D. K., Khera, A., Patel, M. J., Lindsey, J. B., Grundy, S. M., de Lemos, J. A.
(2007). The Association of Differing Measures of Overweight and Obesity With Prevalent Atherosclerosis: The Dallas Heart Study. J Am Coll Cardiol
50: 752-759
[Abstract][Full Text]
Lopaschuk, G. D., Folmes, C. D.L., Stanley, W. C.
(2007). Cardiac Energy Metabolism in Obesity. Circ. Res.
101: 335-347
[Abstract][Full Text]
Kenchaiah, S., Pocock, S. J., Wang, D., Finn, P. V., Zornoff, L. A.M., Skali, H., Pfeffer, M. A., Yusuf, S., Swedberg, K., Michelson, E. L., Granger, C. B., McMurray, J. J.V., Solomon, S. D., for the CHARM Investigators,
(2007). Body Mass Index and Prognosis in Patients With Chronic Heart Failure: Insights From the Candesartan in Heart failure: Assessment of Reduction in Mortality and morbidity (CHARM) Program. Circulation
116: 627-636
[Abstract][Full Text]
Ingelsson, E., Sundstrom, J., Lind, L., Riserus, U., Larsson, A., Basu, S., Arnlov, J.
(2007). Low-grade albuminuria and the incidence of heart failure in a community-based cohort of elderly men. Eur Heart J
28: 1739-1745
[Abstract][Full Text]
Tsutamoto, T., Tanaka, T., Sakai, H., Ishikawa, C., Fujii, M., Yamamoto, T., Horie, M.
(2007). Total and high molecular weight adiponectin, haemodynamics, and mortality in patients with chronic heart failure. Eur Heart J
28: 1723-1730
[Abstract][Full Text]
de Simone, G., Devereux, R. B., Chinali, M., Best, L. G., Lee, E. T., Galloway, J. M., Resnick, H. E., for the Strong Heart Study Investigators,
(2007). Prognostic Impact of Metabolic Syndrome by Different Definitions in a Population With High Prevalence of Obesity and Diabetes: The Strong Heart Study. Diabetes Care
30: 1851-1856
[Abstract][Full Text]
Papas, M. A., Alberg, A. J., Ewing, R., Helzlsouer, K. J., Gary, T. L., Klassen, A. C.
(2007). The Built Environment and Obesity. Epidemiol Rev
0: mxm009v1-
[Abstract][Full Text]
Caples, S. M., Somers, V. K.
(2007). CPAP treatment for obstructive sleep apnoea in heart failure: expectations unmet. Eur Heart J
28: 1184-1186
[Full Text]
Abe, Y., Ono, K., Kawamura, T., Wada, H., Kita, T., Shimatsu, A., Hasegawa, K.
(2007). Leptin induces elongation of cardiac myocytes and causes eccentric left ventricular dilatation with compensation. Am. J. Physiol. Heart Circ. Physiol.
292: H2387-H2396
[Abstract][Full Text]
Shimizu, H., Inoue, K., Mori, M.
(2007). The leptin-dependent and -independent melanocortin signaling system: regulation of feeding and energy expenditure. J Endocrinol
193: 1-9
[Abstract][Full Text]
Cicoira, M., Maggioni, A. P., Latini, R., Barlera, S., Carretta, E., Janosi, A., Soler, J. S., Anand, I., Cohn, J. N., Val-HeFT Investigators,
(2007). Body mass index, prognosis and mode of death in chronic heart failure: Results from the Valsartan Heart Failure Trial. Eur J Heart Fail
9: 397-402
[Abstract][Full Text]
Schmidt, D., Salahudeen, A.
(2007). The Obesity-Survival Paradox in Hemodialysis Patients: Why Do Overweight Hemodialysis Patients Live Longer?. Nutr Clin Pract
22: 11-15
[Abstract][Full Text]
De Keulenaer, G. W., Brutsaert, D. L.
(2007). Systolic and diastolic heart failure: Different phenotypes of the same disease?. Eur J Heart Fail
9: 136-143
[Abstract][Full Text]
Ingelsson, E., Lind, L., Arnlov, J., Sundstrom, J.
(2007). Sleep disturbances independently predict heart failure in overweight middle-aged men. Eur J Heart Fail
9: 184-190
[Abstract][Full Text]
Fauconnier, J., Lanner, J. T., Sultan, A., Zhang, S.-J., Katz, A., Bruton, J. D., Westerblad, H.
(2007). Insulin potentiates TRPC3-mediated cation currents in normal but not in insulin-resistant mouse cardiomyocytes. Cardiovasc Res
73: 376-385
[Abstract][Full Text]
Schaufelberger, M., Rosengren, A.
(2007). Heart failure in different occupational classes in Sweden. Eur Heart J
28: 212-218
[Abstract][Full Text]
Li, C., Ford, E. S, McGuire, L. C, Mokdad, A. H
(2007). Association of metabolic syndrome and insulin resistance with congestive heart failure: findings from the Third National Health and Nutrition Examination Survey. J. Epidemiol. Community Health
61: 67-73
[Abstract][Full Text]
de Krom, M., van der Schouw, Y. T., Hendriks, J., Ophoff, R. A., van Gils, C. H., Stolk, R. P., Grobbee, D. E., Adan, R.
(2007). Common Genetic Variations in CCK, Leptin, and Leptin Receptor Genes Are Associated With Specific Human Eating Patterns. Diabetes
56: 276-280
[Abstract][Full Text]
Avelar, E., Cloward, T. V., Walker, J. M., Farney, R. J., Strong, M., Pendleton, R. C., Segerson, N., Adams, T. D., Gress, R. E., Hunt, S. C., Litwin, S. E.
(2007). Left Ventricular Hypertrophy in Severe Obesity: Interactions Among Blood Pressure, Nocturnal Hypoxemia, and Body Mass. Hypertension
49: 34-39
[Abstract][Full Text]
Previous
