ORIGINAL ARTICLEAssociation Between Direct Measures of Body Composition and Prognostic Factors in Chronic Heart Failure
Section snippets
PATIENTS AND METHODS
Between June 2008 and July 2009, 140 consecutive patients with CHF (systolic and/or diastolic) were recruited from the University of Alberta Heart Function Clinic, Edmonton, Alberta, Canada, a tertiary care clinic staffed by a multidisciplinary team of physicians, specialized nurses, pharmacists, dieticians, and social workers. Patients 18 years or older who were able to give informed consent, who had heart failure diagnosed on the basis of Framingham Heart Study criteria,9 and who were deemed
RESULTS
Of the 221 consecutive eligible patients approached, 140 consented to participate. Reasons for refusal included lack of time, poor noncardiac health, lack of transportation to attend appointments, and unwillingness to undergo x-ray exposure.
Mean age of the cohort was 63 years, 103 (74%) of the patients were male, and 126 (90%) were white. When categorizedaccording to directly measured body fat, 39, 39, and 62 patients were in the low-normal, overweight, and obese body fat groups, respectively (
DISCUSSION
In this cross-sectional study, we found that increasing BMI was significantly associated with lower NT-proBNP levels and lower exercise capacity. However, when directly measuring body composition, we found significant associations between increasing body fat and unfavorable changes in prognostic factors, such as higher inflammation and lower exercise capacity, whereas increasing lean mass was associated with favorable changes, such as better hand-grip strength and lower NT-proBNP levels. To our
CONCLUSION
In this study of patients with CHF in whom body composition was directly measured, using BMI as the measure of body fat lead to misclassification of 41% of patients with CHF. Directly measured body composition was also found to be more closely linked to indicators of prognosis in patients with CHF than BMI. Significant associations were found between increasing body fat and unfavorable changes in certain important CHF prognostic factors, whereas increasing lean body mass was associated with
Acknowledgments
We sincerely thank the study participants, the University of Alberta Heart Function Clinic staff for their support of this study, and Mark Little, Melissa Stafford, Aga Andrzejewska, and Kinga Walter for their assistance with the DEXA scans.
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This study was funded by the University of Alberta Hospital Foundation.
Dr Oreopoulos is supported by a Doctoral Research Award from the Heart and Stroke Foundation of Canada. Dr Johnson holds a Canada Research Chair, and Dr Ezekowitz and Dr Norris hold New Investigator Awards, all from the Canadian Institutes of Health Research. Dr Ezekowitz, Dr McAlister, Dr Norris, and Dr Johnson are supported by the Alberta Heritage Foundation for Medical Research. Dr McAlister is also supported by the Patient Health Management Chair at the University of Alberta. Dr Kalantar-Zadeh is supported by research grants from the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health, an American Heart Association grant in aid, and a philanthropic grant from Mr Harold Simmons. Dr Fonarow is supported by the Ahmanson Foundation (Los Angeles, CA) and holds the Eliot Corday Chair in Cardiovascular Medicine and Science.
This study was presented at Cardiac Sciences Research Day; June 11, 2010; Edmonton, Alberta, Canada.