{
  "abstract": "Background Obesity is associated with adverse outcomes in overt hypertrophic cardiomyopathy, but the prevalence and impact of elevated body mass index (BMI) in early‐stage hypertrophic cardiomyopathy is uncertain. Methods In this post hoc analysis of the randomized VANISH (Valsartan for Attenuating Disease Evolution in Early Sarcomeric Hypertrophic Cardiomyopathy) trial, participants were categorized according to baseline BMI (nonelevated or elevated [≥85th percentile if age <18 years; ≥25 kg/m 2 if age ≥18 years]). Exercise capacity (peak oxygen uptake [milliliters per kilogram per minute]) and cardiac imaging parameters were evaluated by baseline BMI and 2‐year change in BMI. Results Among 171 (96%) participants (mean age, 23±10 years; 39% female sex; 97% White), 82 (48%) had nonelevated BMI and 89 (52%) had an elevated BMI. After covariate adjustment, higher baseline BMI was associated with lower peak oxygen uptake; lower left ventricular systolic and diastolic function; higher left ventricular mass; and higher atrial, ventricular, and extracellular volumes. Similarly, greater 2‐year increases in BMI were associated with greater declines in peak oxygen uptake and greater increases in left ventricular mass. Participants with elevated BMI were more likely to develop late gadolinium enhancement over 2 years (adjusted odds ratio, 3.6 [95% CI, 1.1–11.9]; P =0.033). Valsartan appeared to modestly attenuate 2‐year increases in body weight versus placebo (adjusted mean difference, −3.1% [95% CI, −6.2 to −0.1%]; P =0.042). Baseline BMI did not appear to modify the effect of valsartan on cardiac remodeling ( P interaction =0.96). Conclusions Elevated BMI was common and associated with greater hypertrophic, eccentric, and fibrotic remodeling in early‐stage hypertrophic cardiomyopathy. Two‐year increases in BMI were associated with greater phenotypic progression. These findings suggest prevention and treatment of elevated BMI may attenuate hypertrophic cardiomyopathy progression. Registration URL: https://www.clinicaltrials.gov ; Unique identifier: NCT01912534.",
  "abstract_shown": true,
  "affiliations": [
    "Cardiovascular Division, Brigham and Women's Hospital and Harvard Medical School",
    "Copenhagen University Hospital",
    "University of Pennsylvania Perelman School of Medicine",
    "University of Michigan",
    "Cleveland Clinic Foundation",
    "Heart Institute, University of São Paulo Medical School",
    "Boston Children's Hospital",
    "Johns Hopkins University School of Medicine",
    "Washington University School of Medicine",
    "Stanford University School of Medicine",
    "Children's Hospital of Philadelphia",
    "University of Colorado Anschutz Medical Campus",
    "University of Virginia Health System",
    "Heart Institute, Cincinnati Children's Hospital Medical Center",
    "Vanderbilt University Medical Center",
    "University of Pittsburgh School of Medicine and UPMC",
    "DC Veterans Administration Medical Center"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 26,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "John W. Ostrominski",
      "orcid": "0000-0002-2866-9414"
    },
    {
      "affs": [
        0
      ],
      "name": "Brian L. Claggett",
      "orcid": "0009-0009-1748-4340"
    },
    {
      "affs": [
        0
      ],
      "name": "Michael Jerosch‐Herold",
      "orcid": "0000-0001-9018-6731"
    },
    {
      "affs": [
        1
      ],
      "name": "Anna Axelsson Raja",
      "orcid": "0000-0001-8665-3309"
    },
    {
      "affs": [
        2
      ],
      "name": "Sharlene M. Day",
      "orcid": "0000-0001-9802-7188"
    },
    {
      "affs": [
        3
      ],
      "name": "Mark W. Russell",
      "orcid": "0000-0003-4855-9260"
    },
    {
      "affs": [
        4
      ],
      "name": "Kenneth Zahka"
    },
    {
      "affs": [
        5
      ],
      "name": "Alexandre C. Pereira",
      "orcid": "0000-0002-7782-5540"
    },
    {
      "affs": [
        6
      ],
      "name": "Steven D. Colan",
      "orcid": "0000-0002-7941-0947"
    },
    {
      "affs": [
        7
      ],
      "name": "Anne M. Murphy",
      "orcid": "0000-0001-9254-3202"
    },
    {
      "affs": [
        8
      ],
      "name": "Charles Canter",
      "orcid": "0000-0002-0007-7337"
    },
    {
      "affs": [
        8
      ],
      "name": "Richard G. Bach",
      "orcid": "0000-0002-7249-3727"
    },
    {
      "affs": [
        9
      ],
      "name": "Matthew T. Wheeler",
      "orcid": "0000-0001-8721-3022"
    },
    {
      "affs": [
        10
      ],
      "name": "Joseph W. Rossano",
      "orcid": "0000-0002-8284-0673"
    },
    {
      "affs": [
        2
      ],
      "name": "Anjali T. Owens",
      "orcid": "0000-0002-9669-8495"
    },
    {
      "affs": [
        11
      ],
      "name": "Luisa Mestroni",
      "orcid": "0000-0003-1116-2286"
    },
    {
      "affs": [
        11
      ],
      "name": "Matthew R.G. Taylor",
      "orcid": "0000-0001-9043-0810"
    },
    {
      "affs": [
        12
      ],
      "name": "Amit R. Patel",
      "orcid": "0000-0001-7621-6463"
    },
    {
      "affs": [
        13
      ],
      "name": "Ivan Wilmot"
    },
    {
      "affs": [
        14
      ],
      "name": "Jonathan H. Soslow",
      "orcid": "0000-0001-9194-5330"
    },
    {
      "affs": [
        15
      ],
      "name": "Jason R. Becker",
      "orcid": "0000-0002-2107-8179"
    },
    {
      "affs": [
        0
      ],
      "name": "Neal K. Lakdawala",
      "orcid": "0000-0001-6458-5421"
    },
    {
      "affs": [
        1
      ],
      "name": "Henning Bundgaard",
      "orcid": "0000-0002-0563-7049"
    },
    {
      "affs": [
        16
      ],
      "name": "Jose D. Vargas",
      "orcid": "0000-0002-2005-567X"
    },
    {
      "affs": [
        0
      ],
      "name": "Carolyn Y. Ho",
      "orcid": "0000-0002-7334-7924"
    },
    {
      "name": "for the Valsartan for Attenuating Disease Evolution in Early Sarcomeric Hypertrophic Cardiomyopathy (VANISH) Investigators"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/4g1aqzmnps7j4.bib",
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  "doi": "10.1161/jaha.126.050131",
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  "id": "4g1aqzmnps7j4",
  "issns": [
    "2047-9980"
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  "language": null,
  "licence": "CC-BY-NC",
  "licence_label": "CC BY-NC",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
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  "native_subjects": [
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      "2705|Cardiomyopathy and Myosin Studies"
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  "openalex": "W7221341882",
  "pdf_url": null,
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-20",
  "publisher": "Ovid Technologies (Wolters Kluwer Health)",
  "ris": "https://research.draconitic.com/paper/4g1aqzmnps7j4.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:28Z",
      "native_id": "10.1161/jaha.126.050131",
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      "url": "https://www.ahajournals.org/doi/10.1161/JAHA.126.050131"
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  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2705|Cardiomyopathy and Myosin Studies",
      "subfield": "cardiovascular"
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  "title": "Body Mass Index, Valsartan, and Myocardial Remodeling in Early‐Stage Hypertrophic Cardiomyopathy: A Secondary Analysis of the Randomized VANISH Trial",
  "title_text": "Body Mass Index, Valsartan, and Myocardial Remodeling in Early‐Stage Hypertrophic Cardiomyopathy: A Secondary Analysis of the Randomized VANISH Trial",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:20:28Z",
  "url": "https://research.draconitic.com/paper/4g1aqzmnps7j4",
  "venue": "Journal of the American Heart Association",
  "versions": []
}