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

VAL103

Castillo-Martínez L|Colín-Ramírez E|Orea-Tejeda A|González Islas DG|Rodríguez García WD| Santillán Díaz C|Gutiérrez Rodríguez AE|Vázquez Durán M|Keirans Davies C

Nutrition xxx (2012) 1-6

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

Subjects /Methods: 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 95% on the resistance/reactance graph [bioelectrical impedance vectorial analysis (BIVA)-cachexia]. Clinical, anthropometric, and biochemical data were also evaluated.

Results: 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.

Conclusion: 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.

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