medicine

1. BIRTH WEIGHT,CURRENT WEIGHT,WEIGHT DYNAMISM FROM
BIRTH TO ADULTHOOD AS
MEASURE OF OUTCOME IN HEART FAILURE
INTRODUCTION
• Cardiovascular disease (CVD) remains the leading cause of mortality
worldwide. Traditional risk factors such as age, gender, lipid levels, smoking,
hypertension, and diabetes predict 75-80% of an individual's risk of incident
CVD. more attention is being given to early life exposures, including the prenatal
environment and its impact on birth weight, and their role in the development of
adult chronic disease.
• The “Barker hypothesis” proposes fetal origins of adult disease and is increasingly
supported by many epidemiological studies demonstrating the deleterious
consequences of birth weight outside the normal range. In particular, low birth
weight (LBW) (< 6 lbs.) is consistently associated with increased risk for adult
chronic disease, including cardiovascular disease, type 2 diabetes, and metabolic
syndrome.
• However, the role of birth weight in predicting incident CVD risk has yet to
be explored. Increasing prevalence of maternal obesity has resulted in an
increasing incidence of LGA,1 representing another population that is at risk for
adverse adult outcomes in response to the intrauterine environment.

2. AIM AND OBJECTIVES
• 1)To assess the significance of birth weight for heart failure in adults
• 2)The weight dynamism from birth to adulthood for correlation with heart
failure
MATERIALS AND METHODS
• We carried out study in NIMS hospital from June 2022 to October
2022.Patients coming to cardiology and General medicine OPD were
taken for study .Total of 100patients who satisfied the inclusion and
exclusion criteria were taken into study.The study was accepted by
NIMS ethics committee.Informed written consent was taken for all
patients.
• The initial investigations were done including the NTPro BNP at the
time of visit along with vitals.simultaneously patients weight,height
measured and noted BMI

3. • All the echocardiography examination were performed by cardiac ultrasound
scanner and 2.5-3.5Mhz transducers.patients examined in left lateral position
by precordial M-mode ,two dimension and Doppler echocardiography.The left
ventricular ejection fraction,diastolic dysfunction were measured in
parasternal axis view and 4 chambered view respectively.
• All patients were divided into 2groups.group A has no cardiac symptoms and
not in heart failure.group B patients has failure signs and symptoms.Both
groups were subjected to 2D ECHO,necessary tests and BMI measured.
STATISTICAL ANALYSIS
• All continuous variables were summarized using mean and standard
deviation,Pearson’s chi square test was applied for comparison continuous
variables,all the data was analysed at the end of study and a P value <0.05
is considered as statistically significant.ROC curve is taken for
consideration for cut off age.

4. 51.00%
49.00%
Sex Distribution
Male
Female
Sex No. of Subjects Percentage
Male 51
51.0%
Female 49
49.0%
Total 100
TABLE1:DISTRUBUTION OF
STUDY POPULATION OF BOTH
THE GENDERS IN GROUP A&B
Results

5. 0%
10%
20%
30%
40%
50%
60%
Low Normal
44.0%
56.0%
%
of
Cases
Birth Weight (Kg's)
Birth Weight (Kg's)
Birth Weight (Kg's) No. of Subjects Percentage
Low 44
44.0%
Normal 56
56.0%
Total 100
TABLE2:DISRUBUTION OF
BIRTH WEIGHT IN STUDY
POPULATION

6. 0%
10%
20%
30%
40%
50%
Normal Overweight Obese
42.0%
27.0% 31.0%
%
of
Cases
BMI
BMI
Birth Weight (Kg's)
Group
Total
Cases Controls
Low 44 0 44
Normal 6 50 56
Total 50 50 100
P Value <0.001
(Chi-Square Test)

7. 0
0.5
1
1.5
2
2.5
3
3.5
Cases Controls
2.14
3.01
Mean
Group
Birth Weight (Kg's)
Group
Birth Weight (Kg's)
Mean Std. Deviation
Cases 2.14 0.267
Controls 3.01 0.276

8. 0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
Normal Overweight Obese
0.00%
38.00%
62.00%
84.00%
16.00%
0.00%
%
of
Cases
BMI
BMI Vs Group
Cases
Controls
BMI
Group
Total
Cases Controls
Normal 0 42 42
Overweight 19 8 27
Obese 31 0 31
Total 50 50 100
P Value <0.001
(Chi-Square Test)

9. 0
10
20
30
40
50
60
70
80
90
Cases Controls
85.54
64.66
Mean
Group
Present Weight (Kg's)
Group
Present Weight (Kg's)
P Value
(t-test)
Mean
Std.
Deviation
Cases 85.54 2.815
<0.001
Controls 64.66 3.640

10. RESULTS
• In our study we collected data from 100 subjects.50 patient were either newly
diagnosed heart failure or k/c/o heart failure on medication,50 people were
randomly collected from general population not having heart failure who
come for routine health check up or non cardiac surgical procedure or
attending cardiac or general medicine op for other ailments
• All patients were screened with 2Decho ,LV function was determined ,birth
weight of all patient were collected from patients themselves
• Out of 50 patients in case group age of patient ranges from 50 to
60years.Among the control group,age of patients ranges from 50-
60years.Mean age of patient in case group is 58.4+/- 3.36year.Mean age of
patients in control group is 56.6+/- 3.02years
• Birth weight among the patients with heart failure ranges from 1.5 –
3.5kgs.total number of patients having low birth weight is 44 among case
group.none of patients were having low birth weight in control group and
was statistically significant (p <0.001).thus indicating there is higher
incidence of heart failure in patients having low birth weight.Mean birth
weight among patients with heart failure was 2.14+/_ 0.267kg and among
control group was 3.01+/_ 0.276kg

11. • The present BMI among patients having heart failure
showed that around 19 patients were overweighted and
31 patients were having obesity while among controls 42
patients having normal BMI ,8 patients were overweight
and none were obese mean BMI in patients having heart
failure is 30.61+/_ 1.6kg/m2
• Present weight range among with heart failure is 60-88kg
and among control group is 55-77kg ,mean LVEF
among patients with failure is 28.58% among control is
59.44%
• Mean NT pro BNP among cases were 25,507.36 and
among control group is 215

12. DISCUSSION
• A Yi xin wang,yanping Li,Janeth W.Rich Edwards conducted study states
the observed an additive interaction between descreasing birth weight
and and overweight and obesity especially persisted only among women
and was independent of later life lifestyle factor.
• The study conducted by CJ Smith,KK Ryckman, Jennifer G Robinson
showed the birth weith is independent risk factor for CVD(2), similiarly the
cohort study conducted by xin huang,jun li,jonatahn li the adverse
intrauterine environmental factors that results in low birth weight may
program permanent changes in organ development and metabolism
particularly involved with insulin metabolism hypertension and lipid
metabolism leading to future adult disease (3).One study conducted by
jingyan tian,miayan qui yanquin states that strong inverse relation
between weight and heart failure(4).

13. CONCLUSION
• The low birth weight associated heart failure and has inverse relationship
with cardiovascular function also obese population have increased risk of
heart failure.similiarly severe lv dysfunction was associated with high
present weight
REFFERENCES
• 1.Yi Xin wang,yanping Li, Janeth W,Rich Edwards ,associations of birth
weight and later life lifestyle factors with risk of cardiovascular disease in
USA :A prospective cohort study(2022)
• 2. CJ Smith,KK Ryckman,Jennifer G Robison,The impact of birth weight on
cardiovascular disease risk in the Women's Health Initiative(2015) pages
239-245
• 3. Xin huang,jun li,jonatahn li,Relationship between birth weight and
cardiovascular risk factors in Japanese young adults (2000) pages 907-913
• 4.Jingyan tian,miayan qui yanquin ,Contribution of birth weight and adult
waist circumference to cardiovascular disease risk in a longitudinal study
(2017)