Body composition, lipid profile and clinical parameters are predictors of prognosis in patients with heart failure: Two-year follow-up

• Published in: Clinical nutrition ESPEN 2023-08, Vol.56, p.52-58
• Main Authors: Paixão da Silva, Eduardo, Ranielly dos Santos Avelino, Regina, Zuza Diniz, Rosiane Viana, Dantas de Lira, Niethia Regina, Monteiro Lourenço Queiroz, Salomão Israel, Gomes Dantas Lopes, Márcia Marília, Maurício Sena-Evangelista, Karine Cavalcanti
• Format: Article
• Language: English
• Subjects: Body composition; Clinical outcomes; Dyslipidemia; Fat mass index; Heart failure; Obesity
• ISSN: 2405-4577; 2405-4577
• DOI: 10.1016/j.clnesp.2023.04.029

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. •Patients with New York Heart Association (NYHA) functional classification I/II had better overall survival.•Higher overall survival rates were found in patients without chronic kidney disease.•The severity of HF symptoms and the presence of chronic kidney disease are associated with higher mortality.•Increased fat mass and dyslipidemia are predictors of favorable outcomes in this population.