{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T12:59:24Z","timestamp":1793278764848,"version":"4.5.0"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Heart Failure"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Right ventricular (RV) dysfunction is associated with increased mortality across a spectrum of cardiovascular diseases. The role of obesity in RV dysfunction and adverse outcomes is unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>We examined patients undergoing right heart catheterization between 2005 and 2016 in a hospital-based cohort. Linear regression was used to examine the association of obesity with hemodynamic indices of RV dysfunction (pulmonary artery pulsatility index, right atrial pressure:pulmonary capillary wedge pressure ratio, RV stroke work index). Cox models were used to examine the association of RV function measures with clinical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      Among 8285 patients (mean age, 63 years; 40% women), higher body mass index was associated with worse indices of RV dysfunction, including lower pulmonary artery pulsatility index (\u03b2, \u22120.23; SE, 0.01;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.001), higher right atrium:pulmonary capillary wedge pressure ratio (\u03b2, 0.25; SE, 0.01;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.001), and lower RV stroke work index (\u03b2, \u22120.05; SE, 0.01;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.001). Over median of 7.3 years of follow-up, we observed 3006 mortality and 2004 heart failure hospitalization events. RV dysfunction was associated with a greater risk of mortality (eg, pulmonary artery pulsatility index:hazard ratio, 1.11 per 1-SD increase [95% CI, 1.04\u20131.18]), with similar associations with risk of heart failure hospitalization. Body mass index modified the effect of RV dysfunction on all-cause mortality (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      <jats:sub>interaction<\/jats:sub>\n                      \u22640.005 for PAPi and RA:PCWP ratio), such that the effect of RV dysfunction was more pronounced at higher body mass index.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Patients with obesity had worse hemodynamic measured indices of RV function across a broad hospital-based sample. While RV dysfunction was associated with worse clinical outcomes including mortality and heart failure hospitalization, this association was especially pronounced among individuals with higher body mass index.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circheartfailure.123.010524","type":"journal-article","created":{"date-parts":[[2023,10,27]],"date-time":"2023-10-27T05:01:40Z","timestamp":1698382900000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":20,"title":["Obesity Modifies Clinical Outcomes of Right Ventricular Dysfunction"],"prefix":"10.1161","volume":"16","author":[{"given":"Janet I.","family":"Ma","sequence":"first","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston (J.I.M., E.P., M.H.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8334-4199","authenticated-orcid":true,"given":"Emily K.","family":"Zern","sequence":"additional","affiliation":[{"name":"Providence Heart Institute, Center for Cardiovascular Analytics, Research, and Data Science (CARDS), Providence St. Joseph Health, Portland, OR (E.K.Z.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-6510-0073","authenticated-orcid":true,"given":"Juhi K.","family":"Parekh","sequence":"additional","affiliation":[{"name":"Cardiovascular Institute and Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA (J.K.P., N.O., N.J., D.W., J.E.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ndidi","family":"Owunna","sequence":"additional","affiliation":[{"name":"Cardiovascular Institute and Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA (J.K.P., N.O., N.J., D.W., J.E.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nona","family":"Jiang","sequence":"additional","affiliation":[{"name":"Cardiovascular Institute and Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA (J.K.P., N.O., N.J., D.W., J.E.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dongyu","family":"Wang","sequence":"additional","affiliation":[{"name":"Cardiovascular Institute and Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA (J.K.P., N.O., N.J., D.W., J.E.H.)."},{"name":"Department of Biostatistics, Boston University School of Public Health, MA (D.W.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula K.","family":"Rambarat","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Duke University Medical Center, Durham, NC (P.K.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eugene","family":"Pomerantsev","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston (J.I.M., E.P., M.H.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9264-3243","authenticated-orcid":true,"given":"Michael H.","family":"Picard","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston (J.I.M., E.P., M.H.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7987-4768","authenticated-orcid":true,"given":"Jennifer E.","family":"Ho","sequence":"additional","affiliation":[{"name":"Cardiovascular Institute and Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA (J.K.P., N.O., N.J., D.W., 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