Pragmatic Weight Management Program for Patients With Obesity and Heart Failure With Preserved Ejection Fraction
Background Obesity is associated with heart failure with preserved ejection fraction (HFpEF). Weight loss can improve exercise capacity in HFpEF. However, previously reported methods of weight loss are impractical for widespread clinical implementation. We tested the hypothesis that an intensive lif...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2021-11-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.121.022930 |
| _version_ | 1797884426120593408 |
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| author | Elia C. El Hajj Milad C. El Hajj Brandon Sykes Melissa Lamicq Michael R. Zile Robert Malcolm Patrick M. O’Neil Sheldon E. Litwin |
| author_facet | Elia C. El Hajj Milad C. El Hajj Brandon Sykes Melissa Lamicq Michael R. Zile Robert Malcolm Patrick M. O’Neil Sheldon E. Litwin |
| author_sort | Elia C. El Hajj |
| collection | DOAJ |
| description | Background Obesity is associated with heart failure with preserved ejection fraction (HFpEF). Weight loss can improve exercise capacity in HFpEF. However, previously reported methods of weight loss are impractical for widespread clinical implementation. We tested the hypothesis that an intensive lifestyle modification program would lead to relevant weight loss and improvement in functional status in patients with HFpEF and obesity. Methods and Results Patients with ejection fraction >45%, at least 1 objective criteria for HFpEF, and body mass index ≥30 kg/m2 were offered enrollment in an established 15‐week weight management program that included weekly visits for counseling, weight checks, and provision of meal replacements. At baseline, 15 weeks, and 26 weeks, Minnesota Living With Heart Failure score, 6‐minute walk distance, echocardiography, and laboratory variables were assessed. A total of 41 patients completed the study (mean body mass index, 40.8 kg/m2), 74% of whom lost >5% of their baseline body weight following the 15‐week program. At 15 weeks, mean 6‐minute walk distance increased from 223 to 281 m (P=0.001) and then decreased to 267 m at 26 weeks. Minnesota Living With Heart Failure score improved from 59.9 to 37.3 at 15 weeks (P<0.001) and 37.06 at 26 weeks. Changes in weight correlated with change in Minnesota Living With Heart Failure score (r=0.452; P=0.000) and 6‐minute walk distance (r=−0.388; P<0.001). Conclusions In a diverse population of patients with obesity and HFpEF, clinically relevant weight loss can be achieved with a pragmatic 15‐week program. This is associated with significant improvements in quality of life and exercise capacity. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT02911337. |
| first_indexed | 2024-04-10T04:06:40Z |
| format | Article |
| id | doaj.art-a4812ae3fb464836a8497d4bf9117460 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-10T04:06:40Z |
| publishDate | 2021-11-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-a4812ae3fb464836a8497d4bf91174602023-03-13T05:24:49ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802021-11-01102110.1161/JAHA.121.022930Pragmatic Weight Management Program for Patients With Obesity and Heart Failure With Preserved Ejection FractionElia C. El Hajj0Milad C. El Hajj1Brandon Sykes2Melissa Lamicq3Michael R. Zile4Robert Malcolm5Patrick M. O’Neil6Sheldon E. Litwin7Department of Physiology Louisiana State University New Orleans LATexas Heart Institute Houston TXDivision of Cardiology Medical University of South Carolina Charleston SCDivision of Cardiology Medical University of South Carolina Charleston SCDivision of Cardiology Medical University of South Carolina Charleston SCDepartment of Psychiatry and Behavioral Sciences Weight Management Center Medical University of South Carolina Charleston SCDepartment of Psychiatry and Behavioral Sciences Weight Management Center Medical University of South Carolina Charleston SCDivision of Cardiology Medical University of South Carolina Charleston SCBackground Obesity is associated with heart failure with preserved ejection fraction (HFpEF). Weight loss can improve exercise capacity in HFpEF. However, previously reported methods of weight loss are impractical for widespread clinical implementation. We tested the hypothesis that an intensive lifestyle modification program would lead to relevant weight loss and improvement in functional status in patients with HFpEF and obesity. Methods and Results Patients with ejection fraction >45%, at least 1 objective criteria for HFpEF, and body mass index ≥30 kg/m2 were offered enrollment in an established 15‐week weight management program that included weekly visits for counseling, weight checks, and provision of meal replacements. At baseline, 15 weeks, and 26 weeks, Minnesota Living With Heart Failure score, 6‐minute walk distance, echocardiography, and laboratory variables were assessed. A total of 41 patients completed the study (mean body mass index, 40.8 kg/m2), 74% of whom lost >5% of their baseline body weight following the 15‐week program. At 15 weeks, mean 6‐minute walk distance increased from 223 to 281 m (P=0.001) and then decreased to 267 m at 26 weeks. Minnesota Living With Heart Failure score improved from 59.9 to 37.3 at 15 weeks (P<0.001) and 37.06 at 26 weeks. Changes in weight correlated with change in Minnesota Living With Heart Failure score (r=0.452; P=0.000) and 6‐minute walk distance (r=−0.388; P<0.001). Conclusions In a diverse population of patients with obesity and HFpEF, clinically relevant weight loss can be achieved with a pragmatic 15‐week program. This is associated with significant improvements in quality of life and exercise capacity. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT02911337.https://www.ahajournals.org/doi/10.1161/JAHA.121.022930exerciseheart failure with preserved ejection fractionleft ventricular hypertrophyobesityquality of lifeweight loss |
| spellingShingle | Elia C. El Hajj Milad C. El Hajj Brandon Sykes Melissa Lamicq Michael R. Zile Robert Malcolm Patrick M. O’Neil Sheldon E. Litwin Pragmatic Weight Management Program for Patients With Obesity and Heart Failure With Preserved Ejection Fraction Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease exercise heart failure with preserved ejection fraction left ventricular hypertrophy obesity quality of life weight loss |
| title | Pragmatic Weight Management Program for Patients With Obesity and Heart Failure With Preserved Ejection Fraction |
| title_full | Pragmatic Weight Management Program for Patients With Obesity and Heart Failure With Preserved Ejection Fraction |
| title_fullStr | Pragmatic Weight Management Program for Patients With Obesity and Heart Failure With Preserved Ejection Fraction |
| title_full_unstemmed | Pragmatic Weight Management Program for Patients With Obesity and Heart Failure With Preserved Ejection Fraction |
| title_short | Pragmatic Weight Management Program for Patients With Obesity and Heart Failure With Preserved Ejection Fraction |
| title_sort | pragmatic weight management program for patients with obesity and heart failure with preserved ejection fraction |
| topic | exercise heart failure with preserved ejection fraction left ventricular hypertrophy obesity quality of life weight loss |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.121.022930 |
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