biostudies-literatureUnknown15Reinhardt M<h4>Objective</h4>The study investigates the prognostic impact of body mass index (BMI) in patients hospitalized with heart failure with mildly reduced ejection fraction (HFmrEF).<h4>Background</h4>Limited data regarding the prognostic impact of BMI in patients with HFmrEF is available.<h4>Methods</h4>Consecutive patients with HFmrEF (ie, left ventricular ejection fraction 41-49% and signs and/or symptoms of HF) were retrospectively included at one institution from 2016 to 2022. Risk stratification was performed according to WHO-defined BMI groups. The primary endpoint was all-cause mortality at 30 months (median follow-up). Kaplan-Meier, uni- and multivariable Cox proportional regression analyses were applied for statistics.<h4>Results</h4>1832 consecutive patients with HFmrEF were included with a median BMI of 26.7 kg/m² (IQR 24.0-30.8 kg/m²). Patients with lowest BMI (ie, 18.5-24.9 kg/m²) were associated with highest risk of all-cause mortality at 30 months compared to patients with higher BMI values (40.0% vs 29.0% vs 21.4% vs 20.9%; log rank p = 0.001; HR = 0.721; 95% CI 0.656-0.793; p = 0.001). Even after multivariable adjustment, higher BMI values were associated with improved survival at 30 months (HR = 0.963; 95% CI 0.943-0.985; p = 0.001). In contrast, the risk of HF- related rehospitalization at 30 months was not affected by BMI (log rank p = 0.064).<h4>Conclusion</h4>In patients hospitalized with HFmrEF, lower BMI was associated with increased risk of all-cause mortality at 30 months, suggesting an obesity paradox in HFmrEF.Pragmatic and observational research31-43https://www.ebi.ac.uk/biostudies/studies/S-EPMC10933520biostudies-literatureObesity Paradox in Heart Failure with Mildly Reduced Ejection Fraction.PMC10933520Rusnak JAbumayyaleh MSchupp TAkin IAbel NLau FAkin MBehnes MReinhardt MSchmitt AfalseObesity Paradox in Heart Failure with Mildly Reduced Ejection Fraction.<h4>Objective</h4>The study investigates the prognostic impact of body mass index (BMI) in patients hospitalized with heart failure with mildly reduced ejection fraction (HFmrEF).<h4>Background</h4>Limited data regarding the prognostic impact of BMI in patients with HFmrEF is available.<h4>Methods</h4>Consecutive patients with HFmrEF (ie, left ventricular ejection fraction 41-49% and signs and/or symptoms of HF) were retrospectively included at one institution from 2016 to 2022. Risk stratification was performed according to WHO-defined BMI groups. The primary endpoint was all-cause mortality at 30 months (median follow-up). Kaplan-Meier, uni- and multivariable Cox proportional regression analyses were applied for statistics.<h4>Results</h4>1832 consecutive patients with HFmrEF were included with a median BMI of 26.7 kg/m² (IQR 24.0-30.8 kg/m²). Patients with lowest BMI (ie, 18.5-24.9 kg/m²) were associated with highest risk of all-cause mortality at 30 months compared to patients with higher BMI values (40.0% vs 29.0% vs 21.4% vs 20.9%; log rank p = 0.001; HR = 0.721; 95% CI 0.656-0.793; p = 0.001). Even after multivariable adjustment, higher BMI values were associated with improved survival at 30 months (HR = 0.963; 95% CI 0.943-0.985; p = 0.001). In contrast, the risk of HF- related rehospitalization at 30 months was not affected by BMI (log rank p = 0.064).<h4>Conclusion</h4>In patients hospitalized with HFmrEF, lower BMI was associated with increased risk of all-cause mortality at 30 months, suggesting an obesity paradox in HFmrEF.2024-01-01T00:00:00Z20242025-04-19T05:50:40.589Z2025-04-19T05:50:40.589ZS-EPMC109335203848156810.2147/POR.S444361