ABSTRACT
AIMS: There is an inverse relation between body mass and mortality in large populations of patients with chronic heart failure with a broad range of disease severity. The best measure of body size to describe the relation is not clear. METHODS AND RESULTS: Patients with chronic heart failure (n = 2271, age 71.9 ± 11.3 years; 74.6% male) due to left ventricular systolic dysfunction were followed for a median of 1785 days (inter-quartile range, 874-2311 days) in survivors. We measured body mass index (BMI: weight/height²), ponderal index (PI: weight/height³), and body surface area (BSA). In a subset of 1025 patients, we also calculated the 'Charles index' [weight/(waist² × height)] together with bioimpedance data. During follow-up, 912 patients died. Measures of body mass were strong univariable predictors of outcome, and BSA (χ² = 71.3) was the strongest predictor followed by height (χ² = 68.6), weight (χ² = 57.4), then BMI (χ² = 15.2). The larger the patient's size, the lower the risk of mortality. Body surface area was the single strongest predictor of outcome in a multivariable model including 14 variables. In the subset with bioimpedance data, basal metabolic rate, BSA, weight, BMI, percentage body fat, fat mass, PI, and fat-free mass were all univariable predictors of outcome. CONCLUSION: Measures of body size are strongly related to outcome in patients with chronic heart failure. Body surface area is a stronger predictor of mortality than other measures of body habitus, irrespective of height correction. The greater the overall bulk of the body, the better the survival.
Subject(s)
Body Mass Index , Body Surface Area , Heart Failure/diagnosis , Heart Failure/mortality , Obesity/diagnosis , Cause of Death , Chronic Disease , Cohort Studies , Female , Heart Failure/therapy , Humans , Male , Multivariate Analysis , Obesity/mortality , Predictive Value of Tests , Prognosis , Sensitivity and Specificity , Severity of Illness Index , Survival AnalysisABSTRACT
The effects of perirhinal cortex lesions in rats on spatial memory might depend on the choice of strain. The present study, therefore, compared perirhinal lesions in Sprague-Dawley rats (associated with deficits) with Dark Agouti rats (associated with null effects). Tests of reference memory and working memory in the water maze failed to provide evidence that perirhinal lesions disrupt overall levels of performance (irrespective of strain) or that these lesions have differential effects on the rates of spatial learning in these 2 strains. Strain differences were, however, found, as the Dark Agouti strain was often superior. Furthermore, the perirhinal lesions did have differential effects in the 2 strains, but these did not appear to relate directly to changes in spatial learning.
