Association of cardiac cachexia and atrial fibrillation in heart failure patients

• Published in: International journal of cardiology 2016-11, Vol.223, p.863-866
• Main Authors: Arámbula-Garza, Estefanía, Castillo-Martínez, Lilia, González-Islas, Dulce, Orea-Tejeda, Arturo, Santellano-Juárez, Brenda, Keirns-Davies, Candace, Peláez-Hernández, Viridiana, Sánchez-Santillán, Rocío, Pineda-Juárez, Juan, Cintora-Martínez, Carlos, Pablo-Santiago, Ruth
• Format: Article
• Language: English
• Subjects: Aged; Atrial fibrillation; Atrial Fibrillation - diagnosis; Atrial Fibrillation - etiology; Atrial Fibrillation - physiopathology; Cachexia - diagnosis; Cachexia - etiology; Cachexia - physiopathology; Cardiac cachexia; Cardiovascular; Case-Control Studies; Electric Impedance; Female; Heart failure; Heart Failure - complications; Heart Failure - diagnosis; Heart Failure - epidemiology; Heart Failure - physiopathology; Humans; Male; Mexico - epidemiology; Middle Aged; Severity of Illness Index; Stroke Volume; Vectorcardiography - methods; Ventricular Function, Left
• ISSN: 0167-5273; 1874-1754
• DOI: 10.1016/j.ijcard.2016.08.318

Abstract Background Cachexia is a common complication in patients with advanced heart failure (HF) associated with inflammatory response activation. Atrial Fibrillation (AF) is the most frequent arrhythmia (26%), probably both exacerbate the cardiac cachexia (CC). Objectives Evaluate the association of cardiac cachexia and atrial fibrillation in heart failure patients. Material and Methods In a case control study, CC was diagnosed by electrical bioimpedance with vectorial analysis (BIVA). Subjects with congenital heart disease, cancer, HIV, drug use and other causes than HF were excluded. Results Of the 359 subjects analyzed (men: 52.9%) median age 65 years (55-74). Those with CC were older [72 (61-67)] vs without [62 (52-70) years old, p < 0.01]. During follow-up 47.8% of subjects developed CC and 17.27% AF, this was significantly more frequent in cachectic patients CC (23% vs 12.11%, OR: 2.17, 95% CI: 1.19-4.01, p = 0.006). Subjects, with AF had lower left ventricular ejection fraction (25.49 ± 12.96 vs. 32.01 ± 15.02, p = 0.08), lower posterior wall thickness (10.03 ± 2.12 vs. 11.00 ± 2.47, p = 0.007), larger diameter of the left atrium (49.87 ± 9.84 vs. 42.66 ± 7.56, p < 0.001), and a higher prevalence of CC (85.42% vs. 69.77%, p = 0.028). The 50.58% of was in NYHA class I. In NYHA III, 22.95% were in AF vs. 12.10% with not AF ( p = 0.027). Conclusion The frequent coexistence of CC and AF as HF complications indicate greater severity of HF, regardless of its type of HF.