title: Association of cardiac cachexia and atrial fibrillation in heart failure patients.
abstract: BACKGROUND
  Cachexia is a common complication in patients with advanced heart failure (HF) associated with inflammatory response activation. Atrial fibrillation (AF) is the most frequent arrhythmia (26%), probably both exacerbate the cardiac cachexia (CC).
  
  
  OBJECTIVE
  Evaluate the association of cardiac cachexia and atrial fibrillation in heart failure patients.
  
  
  METHODS
  In a case control study, CC was diagnosed by electrical bioimpedance with vectorial analysis (BIVA). Subjects with congenital heart disease, cancer, HIV, drug use and other causes than HF were excluded.
  
  
  RESULTS
  Of the 359 subjects analyzed (men: 52.9%) median age 65years (55-74). Those with CC were older [72 (61-67)] vs. without [62 (52-70) years old, p<0.01]. During follow-up 47.8% of subjects developed CC and 17.27% AF, this was significantly more frequent in cachectic patients CC (23% vs 12.11%, OR: 2.17, 95% CI: 1.19-4.01, p=0.006). Subjects, with AF had lower left ventricular ejection fraction (25.49±12.96 vs. 32.01±15.02, p=0.08), lower posterior wall thickness (10.03±2.12 vs. 11.00±2.47, p=0.007), larger diameter of the left atrium (49.87±9.84 vs. 42.66±7.56, p<0.001), and a higher prevalence of CC (85.42% vs. 69.77%, p=0.028). The 50.58% of was in NYHA class I. In NYHA III, 22.95% were in AF vs. 12.10% with not AF (p=0.027).
  
  
  CONCLUSIONS
  The frequent coexistence of CC and AF as HF complications indicate greater severity of HF, regardless of its type of HF.
authors: Heart Failure and Respiratory Distress Clinic, Cardiology Department, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Mexico; Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán" Mexico City, Mexico.
authors: Estefanía
authors: E
authors: Arámbula-Garza
authors: Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán" Mexico City, Mexico.
authors: Lilia
authors: L
authors: Castillo-Martínez
authors: Heart Failure and Respiratory Distress Clinic, Cardiology Department, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Mexico.
authors: Dulce
authors: D
authors: González-Islas
authors: Heart Failure and Respiratory Distress Clinic, Cardiology Department, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Mexico.
authors: Arturo
authors: A
authors: Orea-Tejeda
authors: Heart Failure and Respiratory Distress Clinic, Cardiology Department, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Mexico.
authors: Brenda
authors: B
authors: Santellano-Juárez
authors: Massachusetts General Hospital Interpreter Services, Boston, MA 02114, USA.
authors: Candace
authors: C
authors: Keirns-Davies
authors: Heart Failure and Respiratory Distress Clinic, Cardiology Department, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Mexico.
authors: Viridiana
authors: V
authors: Peláez-Hernández
authors: Heart Failure and Respiratory Distress Clinic, Cardiology Department, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Mexico.
authors: Rocío
authors: R
authors: Sánchez-Santillán
authors: Heart Failure and Respiratory Distress Clinic, Cardiology Department, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Mexico.
authors: Juan
authors: J
authors: Pineda-Juárez
authors: Heart Failure and Respiratory Distress Clinic, Cardiology Department, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Mexico.
authors: Carlos
authors: C
authors: Cintora-Martínez
authors: Heart Failure and Respiratory Distress Clinic, Cardiology Department, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Mexico.
authors: Ruth
authors: R
authors: Pablo-Santiago
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D002100:Cachexia / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D016022:Case-Control Studies; D017097:Electric Impedance; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D006801:Humans; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D012720:Severity of Illness Index; D013318:Stroke Volume; D014672:Vectorcardiography / Q000379:methods; D016277:Ventricular Function, Left
keywords: Atrial fibrillation; Cardiac cachexia; Heart failure