Heart Failure and Respiratory Distress Clinic, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Mexico City, Mexico.
Heart Failure and Respiratory Distress Clinic, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Mexico City, Mexico.
Heart Lung. 2020 Jan-Feb;49(1):42-47. doi: 10.1016/j.hrtlng.2019.07.003. Epub 2019 Aug 15.
Heart Failure (HF) patients developed changes in body composition as overhydration, muscle-skeletal wear and cardiac cachexia (CC). The possible factors involved in the development of CC in Right Heart Failure (RHF) patients are venous congestion, nutrient malabsorption. However, in HF, the overhydration obscure the loss of fat-free mass and difficult the body composition assessment. Bioelectrical impedance vectorial analysis (BIVA) is a method validated and used for hydration status and body composition assessment in HF. The aim of this study was to investigate the body compositions changes assessment by BIVA in the subjects with and without RHF and evaluate the risk factors for devolvement CC in HF subjects.
Prospective cohort study. Subjects with confirmed diagnoses of HF, >18 years old without CC according to BIVA criteria were included. Subjects with congenital heart disease, cancer, HIV, and end-stage renal disease were excluded. Body composition was an assessment by BIVA. 288 HF patients were evaluated. RHF subjects had an impedance vector reduction (9.26 dR/H and -1.92 dXc/H, T2=14.9, D = 0.45, p<0.001), while subjects without RHF no-showed statistically significant changes (7.57 dR/H and 0.72 dXc/H, T2=3, D = 0.17, p = 0.200). The risks factors to development CC were age, RHF, phase angle < 5°, total body water were risks factors while handgrip strength was a protector factor.
RHF has greater disturbances in body composition and is a risk factor to development CC.
心力衰竭（HF）患者由于水钠潴留、肌肉骨骼磨损和心脏恶病质（CC）而发生身体成分变化。右心衰竭（RHF）患者 CC 发展中涉及的可能因素包括静脉充血、营养吸收不良。然而，在 HF 中，水钠潴留掩盖了去脂体重的丢失，使身体成分评估变得困难。生物电阻抗矢量分析（BIVA）是一种经过验证并用于 HF 患者水合状态和身体成分评估的方法。本研究旨在通过 BIVA 评估 RHF 和无 RHF 患者的身体成分变化，并评估 HF 患者发生 CC 的危险因素。
前瞻性队列研究。纳入符合 HF 诊断标准且>18 岁且根据 BIVA 标准无 CC 的患者。排除患有先天性心脏病、癌症、HIV 和终末期肾病的患者。身体成分通过 BIVA 进行评估。共评估了 288 例 HF 患者。RHF 患者的阻抗向量减小（9.26 dR/H 和-1.92 dXc/H，T2=14.9，D=0.45，p<0.001），而无 RHF 的患者则没有显示出统计学上的显著变化（7.57 dR/H 和 0.72 dXc/H，T2=3，D=0.17，p=0.200）。发生 CC 的危险因素为年龄、RHF、相位角<5°、总水量，而握力是保护因素。
RHF 对身体成分的影响更大，是发生 CC 的危险因素。
