title: Cachexia assessed by bioimpedance vector analysis as a prognostic indicator in chronic stable heart failure patients.
abstract: BACKGROUND
  This study explored whether the cachectic state assessed by bioimpedance vector analysis provides additional prognostic information about mortality from all causes.
  
  
  METHODS
  We included 519 consecutive patients with stable chronic heart failure (mean age 62.5 ± 16.4 y; 286 males). Cachexia was identified in those subjects who fell outside the right lower quadrant of the reference curve of 95% on the resistance/reactance graph [bioelectrical impedance vectorial analysis (BIVA)-cachexia]. Clinical, anthropometric, and biochemical data were also evaluated.
  
  
  RESULTS
  Patients with BIVA-cachexia (n = 196, 37.8%) were older and had significantly lower ejection fraction, handgrip strength, serum albumin, total cholesterol, and triglycerides. The frequency of patients with body mass index < 20, decreased muscle strength, hypoalbuminemia, anemia, anorexia, New York Heart Association functional classes III/IV and edema, as well as creatinine levels, resistance/height, and impedance index was significantly higher in the cachexia group. During 29 ± 11 mo of follow-up, 39 (19.9%) patients with BIVA-cachexia and 38 (11.7%) patients without BIVA-cachexia (P < 0.0001) died.
  
  
  CONCLUSIONS
  The cachectic state is an independent risk factor for mortality in chronic heart failure patients. BIVA could represent a valuable tool to assess presence of cachexia as changes in body cell mass in heart failure patients because provide information additional to weight loss.
authors.affiliation: Heart Failure Clinic, Cardiology Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Del Valle, Benito Juárez CP, Mexico.
authors.forename: Lilia
authors.initials: L
authors.lastname: Castillo-Martínez
authors.forename: Eloisa
authors.initials: E
authors.lastname: Colín-Ramírez
authors.forename: Arturo
authors.initials: A
authors.lastname: Orea-Tejeda
authors.forename: Dulce Gabriela
authors.initials: DG
authors.lastname: González Islas
authors.forename: Wendy Daniella
authors.initials: WD
authors.lastname: Rodríguez García
authors.forename: Cira
authors.initials: C
authors.lastname: Santillán Díaz
authors.forename: Ana Elizabeth
authors.initials: AE
authors.lastname: Gutiérrez Rodríguez
authors.forename: Marisela
authors.initials: M
authors.lastname: Vázquez Durán
authors.forename: Candace
authors.initials: C
authors.lastname: Keirns Davies
mesh_terms: D000367:Age Factors; D000368:Aged; D000740:Anemia; D000855:Anorexia; D015415:Biomarkers / Q000032:analysis; D001823:Body Composition / Q000502:physiology*; D001827:Body Height; D015992:Body Mass Index; D002100:Cachexia / Q000209:etiology / Q000401:mortality / Q000503:physiopathology*; D002908:Chronic Disease; D004487:Edema; D017097:Electric Impedance; D005260:Female; D005500:Follow-Up Studies; D018737:Hand Strength; D006333:Heart Failure / Q000150:complications / Q000401:mortality / Q000503:physiopathology*; D006801:Humans; D034141:Hypoalbuminemia; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status / Q000502:physiology*; D015995:Prevalence; D012307:Risk Factors; D013851:Thinness
chemical_list: D015415:Biomarkers