Abstract 14295: Ongoing Muscle Wasting Despite Stable Weight in Cachectic Heart Failure Patients
Purpose: Cachexia is a complex metabolic syndrome associated with underlying illness and characterized by reduced muscle mass and in some studies also reduced fat mass. Cachexia is defined by unintentional non-oedematous weight loss of at least 5 % in ≤ 12 months. No prospective studies have evaluated changes in body composition over time. Thus we studied, in a prospective manner, alterations in body composition in patients with heart failure (HF) with and without cardiac cachexia.
Methods: From 2009-2011 we screened 627 HF patients and identified 19 with reduced left ventricular ejection fraction (LVEF) and cachexia as defined. They were matched with 19 HF patients without cachexia with a single match by kidney function, age and gender. Body composition was assessed 3 times during 12 months by dual energy x-ray absorptiometry (DXA) measuring muscle and fat mass as well as fat distribution (abdominal and gynoid fat). No changes in diuretic dosage were made in this period.
Results: The cachectic patients (Demographics: see table) had at baseline lower BMI 22.3 (SEM 0.6) vs. 26.1 (SEM 0.9) kg/m², p< 0.0001, lower abdominal fat % 27.4% (SEM 2.3) vs. 37.5% (SEM 2.4), p=0006 and lower total fat %, p=0.013. Difference in muscle mass, indexed with respect to height, was 269 (SEM 7) vs. 289 (SEM 8) (g/cm), p=0.053. At follow up BMI was unaffected in both groups. In HF with cachexia abdominal fat % increased from 27.5 to 29.7 %, total fat % increased from 25.9 to 27.8 % and muscle mass decreased from 71.4 to 69.7 %, all p-values < 0.05. No such changes were observed in the control group.
Conclusion: In conclusion, weight loss in cardiac cachexia does not appear linearly. Initially the weight loss consists of both muscle mass and total/abdominal fat mass. During follow up the weight might stabilize despite an ongoing muscle wasting. The latter might explain the poor prognosis in HF with cachexia.
- © 2012 by American Heart Association, Inc.