Prognostic impact of muscle and fat mass in patients with heart failure
Abstract Background Cachexia, characterized by loss of muscle with or without loss of fat mass, is a poor prognostic factor in patients with heart failure (HF). However, there is limited investigation on the prognostic impact of muscle and fat mass separately in HF. We hypothesized that muscle and f...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2021-06-01
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| Series: | Journal of Cachexia, Sarcopenia and Muscle |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/jcsm.12702 |
| _version_ | 1797205025936637952 |
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| author | Masaaki Konishi Eiichi Akiyama Yasushi Matsuzawa Ryosuke Sato Shinnosuke Kikuchi Hidefumi Nakahashi Nobuhiko Maejima Noriaki Iwahashi Masami Kosuge Toshiaki Ebina Kiyoshi Hibi Toshihiro Misumi Stephan vonHaehling Stefan D. Anker Kouichi Tamura Kazuo Kimura |
| author_facet | Masaaki Konishi Eiichi Akiyama Yasushi Matsuzawa Ryosuke Sato Shinnosuke Kikuchi Hidefumi Nakahashi Nobuhiko Maejima Noriaki Iwahashi Masami Kosuge Toshiaki Ebina Kiyoshi Hibi Toshihiro Misumi Stephan vonHaehling Stefan D. Anker Kouichi Tamura Kazuo Kimura |
| author_sort | Masaaki Konishi |
| collection | DOAJ |
| description | Abstract Background Cachexia, characterized by loss of muscle with or without loss of fat mass, is a poor prognostic factor in patients with heart failure (HF). However, there is limited investigation on the prognostic impact of muscle and fat mass separately in HF. We hypothesized that muscle and fat mass have different effects on the prognosis of HF. Methods This was an observational cohort study of 418 patients (59% were men) admitted with a diagnosis of HF (71 ± 13 years [mean ± standard deviation]), with left ventricular ejection fraction (LVEF) of 39 ± 16%, including 31.3%, 14.8%, and 53.8% of patients with preserved LVEF (LVEF ≥ 50%), mid‐range LVEF (40–50%), and reduced (<40%) LVEF, respectively. Dual‐energy X‐ray absorptiometry was performed with the patients in the stable state after decongestion therapy. Results The mean body mass index of patients was 22.1 ± 4.6 kg/m2, and the mean appendicular skeletal mass (ASM) index was 6.88 ± 1.23 kg/m2 in men and 5.59 ± 0.92 in women; 54.1% of the patients showed reduced muscle mass defined by the international cut‐off value (7.0 kg/m2 for men and 5.4 for women). The mean fat mass was 20.4 ± 7.2% in men and 27.2 ± 8.6% in women. During a median follow‐up of 37 months, 92 (22.0%) of 418 patients with HF died (1 and 3 year mortality: 8.4% and 17.3%, respectively). Lower values of both skeletal muscle and fat mass were independently associated with increased risk of mortality adjusted for age, sex, haemoglobin, New York Heart Association functional class, and height squared (hazard ratio with 95% confidence interval of 0.825 [0.747–0.908] per 1 kg increase of ASM, P < 0.001, and 0.954 [0.916–0.993] per 1 kg increase of fat mass, P = 0.018, respectively). Conclusions More than half of the patients with HF showed reduced muscle mass. Lower values of both muscle and fat mass were associated with higher mortality in HF. |
| first_indexed | 2024-04-24T08:44:34Z |
| format | Article |
| id | doaj.art-af73026d02004981b6117ffec8da688e |
| institution | Directory Open Access Journal |
| issn | 2190-5991 2190-6009 |
| language | English |
| last_indexed | 2024-04-24T08:44:34Z |
| publishDate | 2021-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Cachexia, Sarcopenia and Muscle |
| spelling | doaj.art-af73026d02004981b6117ffec8da688e2024-04-16T14:00:27ZengWileyJournal of Cachexia, Sarcopenia and Muscle2190-59912190-60092021-06-0112356857610.1002/jcsm.12702Prognostic impact of muscle and fat mass in patients with heart failureMasaaki Konishi0Eiichi Akiyama1Yasushi Matsuzawa2Ryosuke Sato3Shinnosuke Kikuchi4Hidefumi Nakahashi5Nobuhiko Maejima6Noriaki Iwahashi7Masami Kosuge8Toshiaki Ebina9Kiyoshi Hibi10Toshihiro Misumi11Stephan vonHaehling12Stefan D. Anker13Kouichi Tamura14Kazuo Kimura15Division of Cardiology Yokohama City University Medical Center Yokohama JapanDivision of Cardiology Yokohama City University Medical Center Yokohama JapanDivision of Cardiology Yokohama City University Medical Center Yokohama JapanDivision of Cardiology Yokohama City University Medical Center Yokohama JapanDivision of Cardiology Yokohama City University Medical Center Yokohama JapanDivision of Cardiology Yokohama City University Medical Center Yokohama JapanDivision of Cardiology Yokohama City University Medical Center Yokohama JapanDivision of Cardiology Yokohama City University Medical Center Yokohama JapanDivision of Cardiology Yokohama City University Medical Center Yokohama JapanDivision of Cardiology Yokohama City University Medical Center Yokohama JapanDivision of Cardiology Yokohama City University Medical Center Yokohama JapanDepartment of Biostatistics Yokohama City University School of Medicine Yokohama JapanDepartment of Cardiology and Pneumology; German Center for Cardiovascular Research (DZHK), partner site Göttingen University of Göttingen Medical Center Göttingen GermanyDepartment of Cardiology (CVK); and Berlin Institute of Health Center for Regenerative Therapies (BCRT); German Centre for Cardiovascular Research (DZHK) partner site Berlin Charité Universitätsmedizin Berlin Berlin GermanyDepartment of Medical Science and Cardiorenal Medicine Yokohama City University Graduate School of Medicine Yokohama JapanDivision of Cardiology Yokohama City University Medical Center Yokohama JapanAbstract Background Cachexia, characterized by loss of muscle with or without loss of fat mass, is a poor prognostic factor in patients with heart failure (HF). However, there is limited investigation on the prognostic impact of muscle and fat mass separately in HF. We hypothesized that muscle and fat mass have different effects on the prognosis of HF. Methods This was an observational cohort study of 418 patients (59% were men) admitted with a diagnosis of HF (71 ± 13 years [mean ± standard deviation]), with left ventricular ejection fraction (LVEF) of 39 ± 16%, including 31.3%, 14.8%, and 53.8% of patients with preserved LVEF (LVEF ≥ 50%), mid‐range LVEF (40–50%), and reduced (<40%) LVEF, respectively. Dual‐energy X‐ray absorptiometry was performed with the patients in the stable state after decongestion therapy. Results The mean body mass index of patients was 22.1 ± 4.6 kg/m2, and the mean appendicular skeletal mass (ASM) index was 6.88 ± 1.23 kg/m2 in men and 5.59 ± 0.92 in women; 54.1% of the patients showed reduced muscle mass defined by the international cut‐off value (7.0 kg/m2 for men and 5.4 for women). The mean fat mass was 20.4 ± 7.2% in men and 27.2 ± 8.6% in women. During a median follow‐up of 37 months, 92 (22.0%) of 418 patients with HF died (1 and 3 year mortality: 8.4% and 17.3%, respectively). Lower values of both skeletal muscle and fat mass were independently associated with increased risk of mortality adjusted for age, sex, haemoglobin, New York Heart Association functional class, and height squared (hazard ratio with 95% confidence interval of 0.825 [0.747–0.908] per 1 kg increase of ASM, P < 0.001, and 0.954 [0.916–0.993] per 1 kg increase of fat mass, P = 0.018, respectively). Conclusions More than half of the patients with HF showed reduced muscle mass. Lower values of both muscle and fat mass were associated with higher mortality in HF.https://doi.org/10.1002/jcsm.12702SarcopeniaCachexiaFrailtySkeletal muscleFat massHeart failure |
| spellingShingle | Masaaki Konishi Eiichi Akiyama Yasushi Matsuzawa Ryosuke Sato Shinnosuke Kikuchi Hidefumi Nakahashi Nobuhiko Maejima Noriaki Iwahashi Masami Kosuge Toshiaki Ebina Kiyoshi Hibi Toshihiro Misumi Stephan vonHaehling Stefan D. Anker Kouichi Tamura Kazuo Kimura Prognostic impact of muscle and fat mass in patients with heart failure Journal of Cachexia, Sarcopenia and Muscle Sarcopenia Cachexia Frailty Skeletal muscle Fat mass Heart failure |
| title | Prognostic impact of muscle and fat mass in patients with heart failure |
| title_full | Prognostic impact of muscle and fat mass in patients with heart failure |
| title_fullStr | Prognostic impact of muscle and fat mass in patients with heart failure |
| title_full_unstemmed | Prognostic impact of muscle and fat mass in patients with heart failure |
| title_short | Prognostic impact of muscle and fat mass in patients with heart failure |
| title_sort | prognostic impact of muscle and fat mass in patients with heart failure |
| topic | Sarcopenia Cachexia Frailty Skeletal muscle Fat mass Heart failure |
| url | https://doi.org/10.1002/jcsm.12702 |
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