Association of body composition of patients with chronic heart failure with the course of the disease

Aim. To identify the relationship between the nutritional status of patients suffering from chronic heart failure (CHF) and their clinical condition.

Materials and methods. The study involved 298 people: 115 men and 183 women (the average age was 61 years). After body composition assessment, the patients were divided into 5 groups: group 1 – reduced weight + sarcopenia (n=45); group 2 – normal weight + sarcopenia (n=79); group 3 – normal weight without sarcopenia (n=49); 4th group – obesity + sarcopenia (n=72); group 5 – obesity without sarcopenia (n=53). The clinical condition of patients in the study groups was assessed with the determination of functional class (FC), ejection fraction (EF), and the analysis of laboratory parameters such as C-reactive protein (CRP), N-terminal natriuretic propeptide B-type (NT-proBNP) and galectin‑3 was carried out.

Results. The most unfavorable course of CHF was determined in patients with reduced body weight and sarcopenia. Thus, in group 1, FC IV was more common than in others (42.2%), FC II was not determined at all. The EF values were the lowest and amounted to 27–36%. The least severe course of CHF was observed in patients with normal body weight without sarcopenia. FC II was more common in group 3 (67.3%). At the same time, the EF was reduced or intermediate. In the obese groups, the course of the disease was less favorable than in the group with normal body composition. However, it is better than in patients with sarcopenia alone. In groups 4 (47.2%) and 5 (52.8%), FC III was more common, and the values of the EF exceeded 50%.

Conclusion. Changes in the body composition of patients suffering from CHF are definitely associated with the severity of the disease and relate to unfavorable prognostic factors. To choose the most effective treatment tactics for patients, it is necessary to identify the clinical phenotypes of CHF with an assessment of the components of body composition.

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