Evidence map›Paper›PMID 29951802›Full record

SynthesisClinical research in cardiology : official journal of the German Cardiac Society2019

Body mass index and all-cause mortality in heart failure patients with normal and reduced ventricular ejection fraction: a dose-response meta-analysis.

Jufen Zhang, Aine Begley, Ruth Jackson, Michael Harrison, Pierpaolo Pellicori, Andrew L Clark, John G F Cleland

Abstract readMeta-AnalysisReview
PubMed Publisher
In one paragraph

Synthesis in Clinical research in cardiology : official journal of the German Cardiac Society, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 51 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
51citing papers in PubMed, 5 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

51 citing papers in PubMed, 5 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Re-appraisal of the obesity paradox in heart failure: a meta-analysis of individual data.Clinical research in cardiology : official journal of the German Cardiac Society · 2021
    Pooled it
  4. Pooled it
  5. Pooled it
  6. Trial
  7. Weight changes in heart failure with preserved ejection fraction: findings from TOPCAT.Clinical research in cardiology : official journal of the German Cardiac Society · 2022
    Trial
  8. Trial
  9. Article
  10. Article
  11. Article
  12. Observational
  13. Article
  14. Article
  15. Article
  16. J-shaped relationship between serum creatinine and mortality in Korean patients with acute heart failure.Clinical research in cardiology : official journal of the German Cardiac Society · 2025
    Observational
  17. Article
  18. Obesity and its management in primary care setting.Journal of diabetes and its complications · 2025
    Review
  19. Review
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Jufen ZhangFaculty of Medical Science, School of Medicine, Anglia Ruskin University, Michael Salmon Building, Bishop Hall Lane, Chelmsford, CM1 1SQ, UK. Jufen.Zhang@anglia.ac.uk.ORCID http://orcid.org/0000-0003-2704-6212
Aine BegleyFaculty of Medical Science, School of Medicine, Anglia Ruskin University, Michael Salmon Building, Bishop Hall Lane, Chelmsford, CM1 1SQ, UK.
Ruth JacksonFaculty of Medical Science, School of Medicine, Anglia Ruskin University, Michael Salmon Building, Bishop Hall Lane, Chelmsford, CM1 1SQ, UK.
Michael HarrisonFaculty of Medical Science, School of Medicine, Anglia Ruskin University, Michael Salmon Building, Bishop Hall Lane, Chelmsford, CM1 1SQ, UK.
Pierpaolo PellicoriInstitute of Health and Wellbeing, University of Glasgow, Glasgow, UK.
Andrew L ClarkDepartment of Cardiology, Castle Hill Hospital, Hull York Medical School, Hull, UK.
John G F ClelandInstitute of Health and Wellbeing, University of Glasgow, Glasgow, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFor patients with heart failure, there is an inverse relation between body mass index (BMI) and mortality, sometimes called the obesity-paradox. However, the relationship might be either U- or J-shaped and might differ between patients with reduced (HFrEF) or preserved left ventricular ejection fraction (HFpEF). We sought to investigate this further in a dose-response meta-analysis of published studies.

methodsPubMed and Embase from June 1980 to April 2017 were searched for prospective cohort studies evaluating associations between BMI and all-cause mortality in patients with HFrEF (LVEF < 40%) or HFpEF (LVEF ≥ 50%). Summary estimated effect sizes were obtained by using a random-effects model. Potential non-linear relationships were evaluated by using random-effects restricted cubic spline models.

resultsTen studies were identified that included 96,424 patients of whom 59,263 had HFpEF (mean age 68 years of whom 38% were women) and 37,161 had HFrEF (mean age 60 years of whom 17% were women). For patients with HFpEF, the summary hazard ratio (HR) for all-cause mortality was: 0.93 (95% CI 0.89-0.97) per 5 units increase in BMI (I

conclusionsFor patients with heart failure, the relation between BMI and mortality is U-shaped with a similar nadir of risk for HFpEF and HFrEF at a BMI of 32-33 kg/m

Indexed as

Body Mass IndexHeart FailureObesityAdrenergic beta-AntagonistsCause of DeathDose-Response Relationship, DrugGlobal HealthHumansPrognosisRisk FactorsStroke VolumeSurvival RateVentricular Function, LeftAdrenergic beta-AntagonistsBMIDose–response meta-analysisHFpEFHFrEFMortality

Identifiers

PMID29951802

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.