Multiprofessional Residency in Health - Cardiology, Onofre Lopes University Hospital, Federal University of Rio Grande Do Norte (EPS, RRSA, RVZD, NRDL, MMGDL, KCMSE), Brazil.
Multiprofessional Residency in Health - Cardiology, Onofre Lopes University Hospital, Federal University of Rio Grande Do Norte (EPS, RRSA, RVZD, NRDL, MMGDL, KCMSE), Brazil; Department of Clinical Medicine, Health Sciences Center, Federal University of Rio Grande Do Norte (RVZD), Brazil.
Clin Nutr ESPEN. 2023 Aug;56:52-58. doi: 10.1016/j.clnesp.2023.04.029. Epub 2023 May 4.
Heart failure (HF) is a complex syndrome that leads to changes in body composition and eventually results in unfavorable outcomes.
This study aimed to evaluate body composition, lipid profiles and clinical parameters of patients with HF, and their associations with both survival and unfavorable clinical outcomes.
This prospective cohort study included 94 adults and older people with HF. Body composition was assessed by bioelectrical impedance analysis (BIA). Anthropometric variables and lipid profile were also evaluated. Electronic medical records were checked to collect information on clinical outcomes (mortality and hospitalization), considering a follow-up period of 24 months. Survival was calculated using the Kaplan-Meier estimate, and the curves compared using Log-Rank. The death risk rate (Hazard Ratio, HR) was calculated using Cox's univariate models.
Mean age was 55.1 (13.9) years and there was a higher frequency of males. There was a predominance of HF with reduced ejection fraction, and ischemic etiology. Patients with New York Heart Association (NYHA) functional classification I/II had a better overall survival rate at 24 months than those with NYHA III/IV (univariate HR 4.93 (1.76-13.82); p = 0.001). Greater survival rates were found in patients without chronic kidney disease (CKD) (univariate HR 2.93 (1.59-5.39); p = 0.01). In the multivariate analyses, both dyslipidemia (adjusted HR 3.84 (1.22-12.00); p = 0.021) and increased fat mass index (FMI) were associated with overall survival rate (adjusted HR 3.59 (1, 10-11.74); p = 0.034).
The severity of HF symptoms and the presence of chronic kidney disease are associated with higher mortality. Increased fat mass index and dyslipidemia are predictors of favorable outcomes in this population.
心力衰竭（HF）是一种导致身体成分发生变化并最终导致不良结局的复杂综合征。
本研究旨在评估 HF 患者的身体成分、血脂谱和临床参数，并探讨它们与生存和不良临床结局的关系。
这是一项前瞻性队列研究，纳入了 94 名成人和老年人 HF 患者。通过生物电阻抗分析（BIA）评估身体成分。还评估了人体测量学变量和血脂谱。查阅电子病历收集临床结局（死亡率和住院率）信息，随访时间为 24 个月。使用 Kaplan-Meier 估计计算生存率，并使用对数秩检验比较曲线。使用 Cox 单因素模型计算死亡风险率（危险比，HR）。
平均年龄为 55.1（13.9）岁，男性比例较高。HF 以射血分数降低为主，病因以缺血性为主。NYHA 心功能分级 I/II 级的患者 24 个月总体生存率高于 NYHA Ⅲ/IV 级患者（单因素 HR 4.93（1.76-13.82）；p=0.001）。无慢性肾脏病（CKD）的患者生存率更高（单因素 HR 2.93（1.59-5.39）；p=0.01）。多因素分析显示，血脂异常（调整 HR 3.84（1.22-12.00）；p=0.021）和脂肪质量指数（FMI）增加（调整 HR 3.59（1.00-12.32）；p=0.051）与总体生存率相关。
HF 症状严重程度和 CKD 的存在与死亡率升高相关。FMI 增加和血脂异常是该人群预后良好的预测因素。
