• Patrícia Vogel, Airton Stein, and Aline Marcadenti.
• BSc. Specialist in Clinical Nutrition, Institute of Education and Research, Hospital Moinhos de Vento (IEP/HMV), Porto Alegre, RS, Brazil.
• Sao Paulo Med J. 2016 May 13; 134 (3): 211218211-8.

Context And ObjectivesThe obesity paradox has already been established in relation to heart failure, but it is not known which obesity indicator best reflects this phenomenon. The aim of this study was to evaluate the association between obesity indexes and mortality among patients with heart failure.Design And SettingCohort study conducted in the Department of Cardiology of Hospital Nossa Senhora da Conceição (Brazil).MethodsClinical, demographic, socioeconomic, biochemical and anthropometric data on 116 patients aged 30 to 85 years with a diagnosis of heart failure were evaluated. Arm fat area, body mass index, body surface area, body adiposity index, lipid accumulation product (LAP) and visceral adiposity index (VAI) were calculated. Cox regression was used to perform survival analyses.ResultsAt baseline, the individuals with ischemic heart failure who remained alive showed higher VAI (3.60 ± 3.71 versus 1.48 ± 1.58; P = 0.04) and a trend towards higher LAP, in comparison with the individuals who died. After an average follow-up of 14.3 months, ischemic heart failure patients who had VAI > 1.21 showed 78% lower risk of death (HR 0.12; 95% CI: 0.02-0.67; P = 0.02) and the Kaplan-Meier survival curves showed better prognosis for these individuals (P = 0.005; log-rank test).ConclusionOur results suggest that VAI is a good predictor of better prognosis among ischemic heart failure patients.

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