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

• Published in: Nutrition (Burbank, Los Angeles County, Calif.) Vol. 28; no. 9; pp. 886 - 891
• Main Authors: Castillo-Martínez, Lilia, Colín-Ramírez, Eloisa, Orea-Tejeda, Arturo, González Islas, Dulce Gabriela, Rodríguez García, Wendy Daniella, Santillán Díaz, Cira, Gutiérrez Rodríguez, Ana Elizabeth, Vázquez Durán, Marisela, Keirns Davies, Candace
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.09.2012; Elsevier; Elsevier Limited
• Subjects: Age Factors; Aged; analysis; Anemia; Anorexia; bioelectrical impedance; Bioelectrical impedance vector analysis; Biological and medical sciences; Biomarkers; Biomarkers - analysis; Biomedical research; Body Composition; Body Composition - physiology; Body Height; Body Mass Index; Cachexia; Cachexia - etiology; Cachexia - mortality; Cachexia - physiopathology; cholesterol; Chronic Disease; Chronic illnesses; complications; Disease; Eating disorders; Edema; Electric Impedance; etiology; Feeding. Feeding behavior; Female; Follow-Up Studies; Fundamental and applied biological sciences. Psychology; Gastroenterology and Hepatology; Hand Strength; heart; Heart Failure; Heart Failure - complications; Heart Failure - mortality; Heart Failure - physiopathology; Humans; Hypoalbuminemia; Impedance; Insulin Resistance; Male; males; Methods; Middle Aged; Mortality; muscle strength; New York; Nutritional Status; Nutritional Status - physiology; patients; physiology; physiopathology; Prevalence; Risk Factors; serum albumin; Standard deviation; Thinness; triacylglycerols; Variables; Vertebrates: anatomy and physiology, studies on body, several organs or systems; weight loss; Mexico; New York; Heart failure; Cachexia; Bioelectrical impedance vector analysis; Human; Vertebrata; Chronic; Mammalia; Prognosis; Heart disease; Cardiovascular disease; Impedance
• ISSN: 0899-9007; 1873-1244; 1873-1244
• DOI: 10.1016/j.nut.2011.11.024

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