{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T19:59:35Z","timestamp":1788897575884,"version":"build-2803163510"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2016,3,9]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              In heart failure (\n              <jats:styled-content style=\"fixed-case\">HF<\/jats:styled-content>\n              ), weight loss (\n              <jats:styled-content style=\"fixed-case\">WL<\/jats:styled-content>\n              ) has been associated with an adverse prognosis whereas obesity has been linked to lower mortality (the obesity paradox). The impact of\n              <jats:styled-content style=\"fixed-case\">WL<\/jats:styled-content>\n              in obese patients with\n              <jats:styled-content style=\"fixed-case\">HF<\/jats:styled-content>\n              is incompletely understood. Our objective was to explore the prevalence of\n              <jats:styled-content style=\"fixed-case\">WL<\/jats:styled-content>\n              and its impact on long\u2010term mortality, with an emphasis on obese patients, in a cohort of patients with chronic\n              <jats:styled-content style=\"fixed-case\">HF<\/jats:styled-content>\n              .\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Weight at first visit and the 1\u2010year follow\u2010up and vital status after 3\u00a0years were assessed in 1000 consecutive ambulatory, chronic\n              <jats:styled-content style=\"fixed-case\">HF<\/jats:styled-content>\n              patients (72.7% men; mean age 65.8\u00b112.1\u00a0years). Significant\n              <jats:styled-content style=\"fixed-case\">WL<\/jats:styled-content>\n              was defined as a loss of \u22655% weight between baseline and 1 year. Obesity was defined as body mass index \u226530\u00a0kg\/m\n              <jats:sup>2<\/jats:sup>\n              (N=272). Of the 1000 patients included, 170 experienced significant\n              <jats:styled-content style=\"fixed-case\">WL<\/jats:styled-content>\n              during the first year of follow\u2010up. Mortality was significantly higher in patients with significant\n              <jats:styled-content style=\"fixed-case\">WL<\/jats:styled-content>\n              (27.6% versus 15.3%,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). In univariable Cox regression analysis, patients with significant\n              <jats:styled-content style=\"fixed-case\">WL<\/jats:styled-content>\n              had 2\u2010fold higher mortality (hazard ratio 1.95 [95%\n              <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n              1.39\u20132.72],\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). In multivariable analysis, adjusting for age, sex, body mass index, New York Heart Association functional class, left ventricular ejection fraction,\n              <jats:styled-content style=\"fixed-case\">HF<\/jats:styled-content>\n              duration, ischemic etiology, diabetes, and treatment, significant\n              <jats:styled-content style=\"fixed-case\">WL<\/jats:styled-content>\n              remained independently associated with higher mortality (hazard ratio 1.89 [95%\n              <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n              1.32\u20132.68],\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). Among obese patients with\n              <jats:styled-content style=\"fixed-case\">HF<\/jats:styled-content>\n              , significant\n              <jats:styled-content style=\"fixed-case\">WL<\/jats:styled-content>\n              was associated with an even more ominous prognosis (adjusted hazard ratio for death of 2.38 [95%\n              <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n              1.31\u20134.32],\n              <jats:italic>P<\/jats:italic>\n              =0.004) than that observed in nonobese patients (adjusted hazard ratio 1.83 [95%\n              <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n              1.16\u20132.89],\n              <jats:italic>P<\/jats:italic>\n              =0.01).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Weight loss \u22655% in patients with chronic\n              <jats:styled-content style=\"fixed-case\">HF<\/jats:styled-content>\n              was associated with high long\u2010term mortality, particularly among obese patients with\n              <jats:styled-content style=\"fixed-case\">HF<\/jats:styled-content>\n              .\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.115.002468","type":"journal-article","created":{"date-parts":[[2016,3,25]],"date-time":"2016-03-25T04:04:31Z","timestamp":1458878671000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":68,"title":["Weight Loss in Obese Patients With Heart Failure"],"prefix":"10.1161","volume":"5","author":[{"given":"Elisabet","family":"Zamora","sequence":"first","affiliation":[{"name":"Heart Failure Unit, Hospital Universitari Germans Trias i Pujol, Badalona Barcelona, Spain"},{"name":"Department of Medicine, Universitat Aut\u00f2noma de Barcelona, Barcelona, 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