Body mass index in adults with congenital heart disease

Objective To investigate the status of body mass index (BMI) in adult people with congenital heart disease (ACHD). Methods Five hundred thirty-nine adults with CHD (53.8% men) were seen in the outpatient clinic from 2013 to 2015 and compared to a reference population (n = 1737). The severity of CHD was categorized as mild, moderate, and severe according to standard guidelines. Patients were categorized based on BMI as underweight (<18.5), overweight (25-30), or obese (>30). Echocardiography and magnetic resonance imaging were used to measure ventricular function while exercise capacity was estimated via cardiopulmonary exercise test. Results Adults with CHD had slightly lower BMI than the reference group (24.1 +/- 4.3 vs 24.6 +/- 4.3; P = .012). Men in the mild and severe group (23.9 +/- 3.6; 23.3 +/- 4.4 vs 25.1 +/- 3.7; P = .007; P = .023) and women in the severe group (21.6 +/- 3.3 vs 24.2 +/- 4.7; P < .001) had lower BMI compared to the reference group. In the subgroups, men with ventricular septal defect, coarctation of aorta/ventricular septal defect and Fontan circulation and women with Fontan circulation had lower BMI than the reference group. Underweight was more prevalent in women with severe lesions compared to the reference group (22.2% vs 3.8%; P < .001). BMI was associated with age and exercise capacity in patients with mild and moderate lesions, while higher BMI was related to better ventricular function in women with Fontan circulation. Conclusion Underweight was more prevalent in ACHD patients with severe lesions. Special attention should be paid to the possible existence of underweight-related comorbidities.