Obesity paradox in patients with aortic valve stenosis. Protective effect of body mass index independently of age, disease severity, treatment modality and non-cardiac comorbidities.

An increased body mass index (BMI) is considered a risk factor for cardiovascular (CV) disease and mortality in the general population. However, after the onset of established disease the association between BMI and outcome is paradoxically inverted [2]. In patients with aortic stenosis (AS) contrasting results have been reported. A recent study denied the BMI paradox in AS, but the enrolled population was asymptomatic and relatively young. Notably, in other conditions this phenomenon has been described only in elderly patients with more advanced disease stage. We aimed to assess the prognostic value of BMI in a large population of severe AS patients and to verify its independency from cardiac and non-CV confounding variables.