280 Body composition and prognosis in 511 chronic heart failure patients: results from three European centers

Cicoira, Mariantonietta; Doehner, Wolfram; Jankowska, EA; Zanolla, Luisa; Zardini, P; Ponikowski, Piotr; Poole‐Wilson, P.A.; Banasiak, W.; Anker, Stefan D.

doi:10.1016/s1567-4215(04)90200-7

Cited by 6 publications

(5 citation statements)

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“…It is not entirely irrelevant, which body compartment is being wasted and which is being preserved. According to previous findings [ 1 ], it seems that lean body mass is associated with better quality of life whereas higher fat content is linked to better survival [ 24 ]. Indeed, DEXA scanning in our patients demonstrated clear increase of fat mass and content while lean mass did not change significantly.…”

Section: Discussionmentioning

confidence: 99%

The effects of a high‐caloric protein‐rich oral nutritional supplement in patients with chronic heart failure and cachexia on quality of life, body composition, and inflammation markers: a randomized, double‐blind pilot study

Rozentryt

Haehling

Lainščak

et al. 2010

J cachexia sarcopenia muscle

152

154

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The prevalence of cardiac cachexia in chronic heart failure is approximately 5% to 15% and 18-month mortality rates can reach 50%. Treatment with angiotensin-converting enzyme inhibitors and beta-blockers may confer some benefit but no proven therapy exists. We tested the effects of an oral nutritional supplement in cachectic patients with heart failure. This was a prospective, randomized, double-blind, placebo-controlled pilot study which randomized 29 patients to a high-caloric (600 kcal) high-protein (20 g) oral nutritional supplement or placebo for a duration of 6 weeks in addition to the patients’ usual food intake. At baseline, 6 weeks, and 18 weeks, we measured body weight, quality of life, body composition, heart function, laboratory parameters, and exercise performance. Edema-free body weight increased in 19 of 20 patients receiving intervention at 6 weeks and in 17 of 19 patients at 18 weeks with an average weight gain of 2.0 ± 1.7 kg (3.1 ± 2.4%, p = 0.0001) and 2.3 ± 3.1 kg (3.6 ± 4.7%, p = 0.007) at 6 and 18 weeks, respectively. Most of the weight gain was fat tissue with an absolute gain of 1.5 ± 1.7 kg (p = 0.003) and 1.6 ± 2.7 kg (p = 0.008). A significant improvement in quality of life and decrease in serum levels of tumor necrosis factor-α were observed (p < 0.05 for both). We demonstrated the feasibility of oral nutritional supplement in cachectic patients with heart failure and significant clinical benefit in terms of body size and body composition, laboratory parameters, and quality of life (www.clinicaltrials.gov identifier NCT00654719).

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Section: Discussionmentioning

confidence: 99%

The effects of a high‐caloric protein‐rich oral nutritional supplement in patients with chronic heart failure and cachexia on quality of life, body composition, and inflammation markers: a randomized, double‐blind pilot study

Rozentryt

Haehling

Lainščak

et al. 2010

J cachexia sarcopenia muscle

152

154

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“…Future studies with larger sample size are needed to investigate whether this has direct benefit itself. Interestingly, from unpublished studies it appears that fat mass is more closely related to survival in CHF than lean tissue mass [26]. Clinically, it appears important to test whether also other wasting disorders can be successfully treated with beta blockers as used in patients with CHF.…”

Section: Discussionmentioning

confidence: 99%

Body composition changes in patients with systolic heart failure treated with beta blockers: A pilot study

Lainščak

Keber

Anker

2006

International Journal of Cardiology

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“…Interestingly, neither fat distribution, lean mass nor waist circumference, indirectly reflecting visceral adiposity, have consistently been able to predict mortality in the obese HF population .…”

Section: Arguments Against the Obesity Paradoxmentioning

confidence: 99%

The paradox of obesity cardiomyopathy and the potential for weight loss as a therapy

2015

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Obesity is an independent risk factor for developing heart failure and the combination of the two disease states will prove to be a significant health burden over the coming years. Obesity is likely to contribute to the development of heart failure through a variety of mechanisms, including structural and functional changes, lipotoxicity and steatosis and altered substrate selection. However, once heart failure has developed, it seems that obesity confers a beneficial influence on prognosis in what has been termed the 'obesity paradox'. This may be a statistical phenomenon, but it should be considered that there is truly a protective state in the physiology of obesity. There is little evidence regarding the impact of weight loss in obese heart failure and whether or not this is beneficial. There have been small studies regarding the cardiovascular effects of both dietary weight loss and bariatric surgery, but few in heart failure. This is an important and increasingly relevant clinical question which must be addressed.

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280 Body composition and prognosis in 511 chronic heart failure patients: results from three European centers

Cited by 6 publications

References 0 publications

The effects of a high‐caloric protein‐rich oral nutritional supplement in patients with chronic heart failure and cachexia on quality of life, body composition, and inflammation markers: a randomized, double‐blind pilot study

The effects of a high‐caloric protein‐rich oral nutritional supplement in patients with chronic heart failure and cachexia on quality of life, body composition, and inflammation markers: a randomized, double‐blind pilot study

Body composition changes in patients with systolic heart failure treated with beta blockers: A pilot study

The paradox of obesity cardiomyopathy and the potential for weight loss as a therapy

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