Cachexia assessed by bioimpedance vector analysis as a prognostic indicator in chronic stable heart failure patients

Nutrition. 2012 Sep;28(9):886-91. doi: 10.1016/j.nut.2011.11.024. Epub 2012 Apr 4.

Abstract

Background: This study explored whether the cachectic state assessed by bioimpedance vector analysis provides additional prognostic information about mortality from all causes.

Methods: We included 519 consecutive patients with stable chronic heart failure (mean age 62.5 ± 16.4 y; 286 males). Cachexia was identified in those subjects who fell outside the right lower quadrant of the reference curve of 95% on the resistance/reactance graph [bioelectrical impedance vectorial analysis (BIVA)-cachexia]. Clinical, anthropometric, and biochemical data were also evaluated.

Results: Patients with BIVA-cachexia (n = 196, 37.8%) were older and had significantly lower ejection fraction, handgrip strength, serum albumin, total cholesterol, and triglycerides. The frequency of patients with body mass index < 20, decreased muscle strength, hypoalbuminemia, anemia, anorexia, New York Heart Association functional classes III/IV and edema, as well as creatinine levels, resistance/height, and impedance index was significantly higher in the cachexia group. During 29 ± 11 mo of follow-up, 39 (19.9%) patients with BIVA-cachexia and 38 (11.7%) patients without BIVA-cachexia (P < 0.0001) died.

Conclusions: The cachectic state is an independent risk factor for mortality in chronic heart failure patients. BIVA could represent a valuable tool to assess presence of cachexia as changes in body cell mass in heart failure patients because provide information additional to weight loss.

Publication types

  • Evaluation Study

MeSH terms

  • Age Factors
  • Aged
  • Anemia
  • Anorexia
  • Biomarkers / analysis
  • Body Composition / physiology*
  • Body Height
  • Body Mass Index
  • Cachexia / etiology
  • Cachexia / mortality
  • Cachexia / physiopathology*
  • Chronic Disease
  • Edema
  • Electric Impedance
  • Female
  • Follow-Up Studies
  • Hand Strength
  • Heart Failure / complications
  • Heart Failure / mortality
  • Heart Failure / physiopathology*
  • Humans
  • Hypoalbuminemia
  • Insulin Resistance
  • Male
  • Middle Aged
  • Nutritional Status / physiology*
  • Prevalence
  • Risk Factors
  • Thinness

Substances

  • Biomarkers