title: Sarcopenia evaluated by fat-free mass index is an important prognostic factor in patients with chronic heart failure.
abstract: OBJECTIVE
  Chronic heart failure (CHF) is a major cause of morbidity and mortality, and cardiac cachexia and sarcopenia are serious complications associated with weight loss and increased catabolism. Fat-free mass index (FFMI) is an indicator of resting energy expenditure and is used for the clinical diagnosis of sarcopenia. In the present study, we investigated the impact of sarcopenia, as evaluated by FFMI, on cardiac prognosis in patients with CHF.
  
  
  RESULTS
  We calculated FFMI in 267 CHF patients who were prospectively followed until they died due to cardiac event, or until they were re-hospitalized. Fat-free mass (FFM) was estimated by the formula [FFM (kg)=7.38+0.02908×urinary creatinine (mg/day)] and normalized by the square of the patient's height in meters to calculate FFMI. During the follow-up periods, there were 83 cardiac events, including 19 cardiac deaths. FFMI was lower in patients with cardiac events than in those without (17.0 kg/m(2) vs. 17.6 kg/m(2), P=0.045). Multivariate Cox hazard analysis revealed that decreased FFMI was associated with an unfavorable outcome (adjusted hazard ratio 0.68, 95% confidence interval 0.47-0.98). The patients were divided into two groups according to their median FFMI. The Kaplan-Meier analysis revealed that significantly higher cardiac event rate was observed in the low-FFMI group (log-rank test, P=0.017).
  
  
  CONCLUSIONS
  Decreased FFMI was associated with an unfavorable prognosis in patients with CHF.
authors: Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata, Japan.
authors: Taro
authors: T
authors: Narumi
authors: Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata, Japan. Electronic address: tewatana@med.id.yamagata-u.ac.jp.
authors: Tetsu
authors: T
authors: Watanabe
authors: Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata, Japan.
authors: Shinpei
authors: S
authors: Kadowaki
authors: Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata, Japan.
authors: Tetsuya
authors: T
authors: Takahashi
authors: Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata, Japan.
authors: Miyuki
authors: M
authors: Yokoyama
authors: Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata, Japan.
authors: Daisuke
authors: D
authors: Kinoshita
authors: Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata, Japan.
authors: Yuki
authors: Y
authors: Honda
authors: Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata, Japan.
authors: Akira
authors: A
authors: Funayama
authors: Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata, Japan.
authors: Satoshi
authors: S
authors: Nishiyama
authors: Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata, Japan.
authors: Hiroki
authors: H
authors: Takahashi
authors: Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata, Japan.
authors: Takanori
authors: T
authors: Arimoto
authors: Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata, Japan.
authors: Tetsuro
authors: T
authors: Shishido
authors: Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata, Japan.
authors: Takuya
authors: T
authors: Miyamoto
authors: Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata, Japan.
authors: Isao
authors: I
authors: Kubota
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001823:Body Composition; D002100:Cachexia / Q000453:epidemiology; D016022:Case-Control Studies; D002908:Chronic Disease; D015331:Cohort Studies; D015897:Comorbidity; D016757:Death, Sudden, Cardiac / Q000453:epidemiology*; D018450:Disease Progression; D004734:Energy Metabolism; D005260:Female; D006333:Heart Failure / Q000453:epidemiology / Q000401:mortality*; D006760:Hospitalization; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000453:epidemiology*; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D055948:Sarcopenia / Q000175:diagnosis / Q000453:epidemiology*; D012720:Severity of Illness Index
keywords: Cachexia; Heart failure; Prognosis; Sarcopenia