Phenotypic difference of sarcopenia in the prediction of mortality for elderly patients with heart failure: from CURE-HF registry

Abstract Background Sarcopenia and malnutrition are associated with mortality in elderly patients with heart failure (HF). However, impact of phenotypic difference of sarcopenia on mortality is not well investigated. We hypothesized that evaluation using both body mass index (BMI) and free-fat mass index (FFMI) enabled distinction of phenotypic difference of sarcopenia and risk stratification for mortality in elderly patients with heart failure. Methods In 800 patients who discharged after treatment for HF were prospectively enrolled from 13 medical centers. Body mass index and FFMI was evaluated. Free-fat mass index was calculated dividing the square of the patients' heights in meters into lean body mass. All-cause mortality was followed-up. Patients were divided into 3 subgroups according to BMI and FFMI values, and compared incidence of mortality among them. Results In our study cohort (median age, 78 [range 72–87]), BMI was 21.1 [18.9, 23.8] and FFMI was 16.7 [15.2, 18.0]. 211 patients were experienced all-cause mortality during 631 [266, 983] days follow-up. In Kaplan-Meier analysis, lower BMI and lower FFMI was associated with all-cause mortality (Log-rank p<0.001, p<0.001, respectively). Furthermore, FFMI was an independent predictor of adverse events after adjustment for age, gender, albumin, hemoglobin, creatinine, brain natriuretic peptide, and left ventricular ejection fraction (HR 95% CI: 0.841 (0.745–0.944), p=0.004). In subgroup analysis, comparing with low-BMI and low-FFMI subgroup, better prognosis was observed in the other 2 subgroups (Log-rank p<0.001, p=0.022, Figure 1). Conclusions Phenotypic difference was evident in elderly patients with HF. A combination of BMI and FFMI would be useful for risk stratification of mortality in those patients. Figure 1 Funding Acknowledgement Type of funding source: None

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Prognostic impact of free-fat mass index on elderly patients with acute decompensated heart failure: from CURE-HF registry

European Heart Journal ◽

10.1093/ehjci/ehaa946.1195 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

M Kanai ◽

H Motoki ◽

T Okano ◽

K Kimura ◽

M Minamisawa ◽

...

Keyword(s):

Heart Failure ◽

Ejection Fraction ◽

Elderly Patients ◽

Fat Mass ◽

Left Ventricular ◽

Left Ventricular Ejection ◽

Prognostic Impact ◽

Ventricular Ejection Fraction ◽

Fat Mass Index ◽

All Cause Mortality

Abstract Background Free-Fat Mass Index (FFMI) is an indicator of malnutrition and sarcopenia. We hypothesized that low FFMI would be associated with worse prognosis in elderly patients with heart failure. Methods In 800 patients who discharged after treatment for HF were prospectively enrolled from 13 medical centers. Free-Fat Mass Index was calculated dividing the square of the patients heights in meters into lean body mass. All-cause mortality (cardiovascular, non-cardiovascular) was followed-up by telephone interview and chart review. Results In our study cohort (median age, 78 [range 72–87]), FFMI was 16.7 [15.2, 18.0]. All-cause mortality was observed in 211 patients during 631 [266, 983] days follow-up. In Kaplan-Meier analysis, lower FFMI was associated with all-cause mortality. Furthermore, FFMI was an independent predictor of mortality after adjustment for age, gender, albumin, hemoglobin, creatinine, brain natriuretic peptide, and left ventricular ejection fraction (HR 95% CI: 0.841 (0.745–0.944), p=0.004). In subgroup analysis, low FFMI was associated with both cardiac and non-cardiac mortality in patients with HF with reduced ejection fraction (EF) (Log-rank p=0.002, p=0.013, respectively) (Figure). Furthermore, low FFMI was significantly associated non-cardiac death in patients with preserved EF (Log-rank p=0.033) (Figure). Conclusions Free-Fat Mass Index was significantly associated with mortality in elderly patients with HF. Funding Acknowledgement Type of funding source: None

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P5669Prognostic impact of low body-mass index in elderly patients with heart failure

European Heart Journal ◽

10.1093/eurheartj/ehy566.p5669 ◽

2018 ◽

Vol 39 (suppl_1) ◽

Author(s):

Y Okuma ◽

H Motoki ◽

M Minamisawa ◽

S Suzuki ◽

W Shoin ◽

...

Keyword(s):

Heart Failure ◽

Body Mass Index ◽

Elderly Patients ◽

Body Mass ◽

Patients With Heart Failure ◽

Low Body Mass Index

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body mass index and fat mass index in relation to atopy in school children

10.26226/morressier.5acdc65bd462b8029238d970 ◽

2018 ◽

Author(s):

Ching-Hua Lin

Keyword(s):

Body Mass Index ◽

Body Mass ◽

Fat Mass ◽

School Children ◽

Fat Mass Index

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Association of Body Mass Index With Clinical Outcomes in Patients With Heart Failure With Reduced Ejection Fraction Treated With Sacubitril/Valsartan

Journal of Cardiovascular Pharmacology and Therapeutics ◽

10.1177/10742484211024441 ◽

2021 ◽

pp. 107424842110244

Author(s):

Kazuhiko Kido ◽

Christopher Bianco ◽

Marco Caccamo ◽

Wei Fang ◽

George Sokos

Keyword(s):

Heart Failure ◽

Body Mass Index ◽

Propensity Score ◽

Ejection Fraction ◽

Clinical Outcomes ◽

Body Mass ◽

Normal Weight ◽

Reduced Ejection Fraction ◽

Propensity Score Weighting ◽

Patients With Heart Failure

Background: Only limited data are available that address the association between body mass index (BMI) and clinical outcomes in patients with heart failure with reduced ejection fraction who are receiving sacubitril/valsartan. Methods: We performed a retrospective multi-center cohort study in which we compared 3 body mass index groups (normal, overweight and obese groups) in patients with heart failure with reduced ejection fraction receiving sacubitril/valsartan. The follow-up period was at least 1 year. Propensity score weighting was performed. The primary outcomes were hospitalization for heart failure and all-cause mortality. Results: Of the 721 patients in the original cohort, propensity score weighting generated a cohort of 540 patients in 3 groups: normal weight (n = 78), overweight (n = 181), and obese (n = 281). All baseline characteristics were well-balanced between 3 groups after propensity score weighting. Among our results, we found no significant differences in hospitalization for heart failure (normal weight versus overweight: average hazard ratio [AHR] 1.29, 95% confidence interval [CI] = 0.76-2.20, P = 0.35; normal weight versus obese: AHR 1.04, 95% CI = 0.63-1.70, P = 0.88; overweight versus obese groups: AHR 0.81, 95% CI = 0.54-1.20, P = 0.29) or all-cause mortality (normal weight versus overweight: AHR 0.99, 95% CI = 0.59-1.67, P = 0.97; normal weight versus obese: AHR 0.87, 95% CI = 0.53-1.42, P = 0.57; overweight versus obese: AHR 0.87, 95% CI = 0.58-1.32, P = 0.52). Conclusion: We identified no significant associations between BMI and clinical outcomes in patients diagnosed with heart failure with a reduced ejection fraction who were treated with sacubitril/valsartan. A large-scale study should be performed to verify these results.

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Associations of Body Mass Index and Anthropometric Indicators of Fat Mass and Fat Free Mass with All-cause Mortality among Women in the First and Second National Health and Nutrition Examination Surveys Follow-up Studies

Annals of Epidemiology ◽

10.1016/s1047-2797(02)00417-9 ◽

2003 ◽

Vol 13 (4) ◽

pp. 286-293 ◽

Cited By ~ 61

Author(s):

S Zhu

Keyword(s):

Body Mass Index ◽

Body Mass ◽

Fat Mass ◽

National Health ◽

Fat Free Mass ◽

Anthropometric Indicators ◽

Health And Nutrition ◽

Follow Up Studies ◽

All Cause Mortality

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Body Habitus and Prognosis in Patients With Heart Failure After Acute Decompensation. A Comparison of Survival According to Body-Mass Index

Journal of Cardiac Failure ◽

10.1016/j.cardfail.2010.07.218 ◽

2010 ◽

Vol 16 (9) ◽

pp. S172

Author(s):

Aya Banno ◽

Shun Kohsaka ◽

Kazuki Ohshima ◽

Yutaka Endo ◽

Masashi Takahashi ◽

...

Keyword(s):

Heart Failure ◽

Body Mass Index ◽

Body Mass ◽

Body Habitus ◽

Patients With Heart Failure ◽

Acute Decompensation

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Nutritional status assessment of the Polish Border Guards officers – Body Mass Index or Fat Mass Index?

Proceedings of The Nutrition Society ◽

10.1017/s002966512000333x ◽

2020 ◽

Vol 79 (OCE2) ◽

Author(s):

Anna Anyzewska ◽

Roman Lakomy ◽

Tomasz Lepionka ◽

Ewa Szarska ◽

Ewelina Maculewicz ◽

...

Keyword(s):

Body Mass Index ◽

Nutritional Status ◽

Body Mass ◽

Fat Mass ◽

Well Being ◽

Good Health ◽

Entire Body ◽

Fat Percentage ◽

Fat Mass Index ◽

Status Assessment

AbstractIntroduction:Border Guards service requirements are very specific. Very good health and excellent psycho-physical condition are the main factors that determine effectiveness and reliability of designated tasks. Disorders of nutritional status, such as underweight, overweight or obesity not only impairs well-being, but also are health problem associated with limitation of possibilities to perform Border Guard's tasks and duties and can lead to earlier elimination from the service. The aim of the study was to assess nutritional status, using two indicators: Body Mass Index (BMI) and Fat Mass Index (FMI).Materials and methods:The study was carried out with participation of 259 Border Guards (64 women and 195 men), aged 38 ± 6; years of service: 12 ± 6. An electric bioimpedance method (TANITA MC-780) was used to determine body composition. Body Mass Index (BMI [kg/m2] = body mass [kg] / height2 [m2]) and Fat Mass Index FMI [kg/m2] = fat mass [kg] / height2 [m2]) were calculated for each of the participants.Results and discussion:Examined group of Polish Border Guards officers was characterized by a large variety of assessed anthropometric indicators. According to the BMI classification excess body mass was more often (p < 0.001) observed in men (68%) than in women (25%) and according to the FMI classification excess fat was also more often (p < 0.001) observed in men (55%) than in women (28%). BMI classification of overweight or obese was observed in 41 of participants with the normal FMI level. Fat percentage of women with normal BMI ranged from 11.6 to 33.5% and tat percentage of men with normal BMI ranged from 7.3 to 21.6%. There are difficulties in BMI interpretation in adults with increased physical activity. It seems more reasonable to assess correctness of nutritional status on the basis of an analyze of FMI value, as this indicator assesses degree of fatness, and not the entire body weight, which, in case of uniformed services usually is greater due to extensive muscle mass, which can increase BMI value. It is necessary to take educational activities in the field of health promotion of these people, with a focus on nutrition prevention of metabolic civilization diseases, as well as to motivate Border Guards officers to respect basic principles of proper nutrition to maintain proper body mass and fat mass.

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