title: Cross-talk between the heart and adipose tissue in cachectic heart failure patients with respect to alterations in body composition: a prospective study.
abstract: OBJECTIVE
  Cardiac cachexia (CC) is associated with changes in body composition. Lipolysis and increased energy expenditure caused by A- and B natriuretic peptides (NPs) have been suggested to play a role in CC. We tested the hypothesis that neurohormones and adipokines are associated with body composition in CC and that a progressive loss of fat free mass (FFM) and fat mass (FM) takes place.
  
  
  METHODS
  Body composition with regard to FFM, FM, and body fat distribution was assessed by dual energy X-ray absorptiometry (DXA) in 19 non-diabetic patients with chronic heart failure (CHF) and CC and 38 controls (non-cachectic CHF and individuals with prior myocardial infarction-both n = 19) who were followed for 12 months. Biomarkers of neurohormonal stimulation, inflammation, and endothelial dysfunction were measured.
  
  
  RESULTS
  N-terminal proBNP (NT-proBNP), midregional proANP (MR-proANP), and total adiponectin were elevated in CHF (p<0.001) and correlated inversely to BMI and FM. An inverse correlation was observed between pro-adrenomedullin (MR-proADM) and FFM. During follow up body weight was unaltered in all groups even though FM increased by 1.35 kg (p<0.05) and FFM decreased by 0.5 kg (p<0.05) in CC patients. The latter correlated inversely to baseline NT-proBNP, MR-proANP, and MR-proADM (p<0.05). No correlation to changes in FM was found.
  
  
  CONCLUSIONS
  FM was associated with plasma NPs and total adiponectin at baseline; whereas changes in FM and FFM did not correlate to changes in NPs or adiponectin during follow up. Prospectively, FFM decreased but FM increased, despite stable body weight in CC.
authors.affiliation: Department of Endocrinology, Herlev University Hospital, Denmark; Department of Cardiology, Herlev University Hospital, Denmark. Electronic address: heidichristensen@dadlnet.dk.
authors.forename: Heidi Marie
authors.initials: HM
authors.lastname: Christensen
authors.forename: Caroline
authors.initials: C
authors.lastname: Kistorp
authors.forename: Morten
authors.initials: M
authors.lastname: Schou
authors.forename: Niels
authors.initials: N
authors.lastname: Keller
authors.forename: Bo
authors.initials: B
authors.lastname: Zerahn
authors.forename: Jan
authors.initials: J
authors.lastname: Frystyk
authors.forename: Allan
authors.initials: A
authors.lastname: Flyvbjerg
authors.forename: Jens
authors.initials: J
authors.lastname: Faber
mesh_terms: D015502:Absorptiometry, Photon; D000273:Adipose Tissue / Q000378:metabolism / Q000503:physiopathology*; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D001823:Body Composition; D002100:Cachexia / Q000209:etiology* / Q000503:physiopathology; D002908:Chronic Disease; D005260:Female; D006321:Heart / Q000503:physiopathology*; D006333:Heart Failure / Q000150:complications / Q000378:metabolism / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D045265:Natriuretic Peptides / Q000378:metabolism; D011446:Prospective Studies
chemical_list: D015415:Biomarkers; D045265:Natriuretic Peptides
keywords: Adipose tissue; CC; CHF; CV; Cardiac Cachexia; Chronic Heart Failure; DXA; FFM; FM; FPLC; HMW; HOMA-IR; Hb1Ac; Hs-CRP; IHD; IL-6; IQR; LOCF; LVEF; MDRD; MR-proADM; MR-proANP; N-terminal pro-B-type natriuretic peptide; NPs; NT-proBNP; NYHA class; Natriuretic peptides; New York heart association classification; SEM; cardiac cachexia; chronic heart failure; coefficient of variation; dual energy X-ray absorptiometry; eGFR; estimated glomerular filtration rate; fast protein liquid chromatography; fat free mass; fat mass; glycosylated haemoglobin; high sensitive C-reactive protein; high-molecular weight; homeostasis model assessment of insulin resistance; interleukin-6; interquartile range; ischemic heart disease; last observation carried forward; left ventricular ejection fraction; midregional pro-A-type natriuretic peptide; midregional pro-adrenomedullin; modification of Diet in Renal Disease; natriuretic peptides; standard error of mean