Body composition and echocardiographic abnormalities associated to anemia and volume overload in heart failure patients.
BACKGROUND
Heart failure (HF) patients with hemodilutional anemia had a worse prognosis than those with true anemia. Volume overload (VO) in anemic patients must be identified in order to select the best treatment.


METHODS
We assessed the prevalence of anemia and VO in systolic and diastolic HF patients, and its effects on clinical status, body composition, and quality of life (QOL). Anemia was defined according to the OMS criteria and VO was assessed by bioelectrical impedance analysis (BIA). Echocardiography variables were also obtained.


RESULTS
We studied 132 HF patients, 59.1% with systolic and 40.9% with diastolic HF. Anemia was present in 29.5% patients with systolic and 24.1% with diastolic HF (P=0.7). Anemic patients in the systolic HF group tend to be worse functional class than the non-anemic subjects; moreover, in both groups of cardiac dysfunction, the anemic patients had less grip strength, lower body mass index (BMI) and waist and hip circumferences, and a higher percentage of extracellular water (ECW), a higher proportion of patients with total serum cholesterol concentration below the 25th percentile, and a lower serum albumin. When patients were divided in 4 subgroups according to the presence of anemia and/or VO, we observed that VO affected the body composition not only through lower BMI, and waist and hip circumferences but also through a lower phase angle. Systolic HF patients with anemia and VO had the highest dimension of left atrium and pulmonary artery pressure (PAP) levels.


CONCLUSIONS
Anemia is common in HF and its prevalence is similar in systolic and diastolic HF patients. Anemia was associated to VO, less grip strength and body composition abnormalities; however, VO was related to more severe body composition and echocardiographic abnormalities, as well as to an impairment of QOL. So that, it is important to differentiate between those who have anemia associated to VO and those who have true anemia.
Colín-Ramírez
Eloisa
E
Heart Failure Clinic, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Mexico City, México.
Castillo-Martínez
Lilia
L
Orea-Tejeda
Arturo
A
Asensio Lafuente
Enrique
E
Torres Villanueva
Fabiola
F
Rebollar González
Verónica
V
Narváez David
Rene
R
Dorantes García
Joel
J
D000740:Anemia / Q000097:blood / Q000453:epidemiology* / Q000209:etiology; D000886:Anthropometry; D001810:Blood Volume; D001823:Body Composition; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D003937:Diagnosis, Differential; D004452:Echocardiography; D017097:Electric Impedance; D005260:Female; D018737:Hand Strength; D006333:Heart Failure / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life