Abnormal fluid distribution and low handgrip strength index as predictors of mortality in Mexican patients with chronic heart failure

Background and aim: Frailty phenotype (FP) is very common in heart failure (HF) and both syndromes worsen one another. The aim of this study is to first describe FP in a sample of Portuguese patients with HF, and to analyse its association with nutritional and clinical statuses, namely, muscle mass, obesity and functional class. Methods and results: In this cross-sectional study, a sample of 136 outpatients with HF (24e81 years, 33.8% women) were randomly selected from the appointments' listings of a HF and Transplant clinic in a Portuguese University Hospital. FP was assessed according to Fried et al. muscle mass was estimated from the mid-upper arm muscle circumference; weight status was assessed using the body mass index; HF functional classes were registered. The association between participants' characteristics and FP categories was analysed using logistic ordinal regression. The frequency of pre-frailty and frailty is 57.4% and 15.4%, respectively. Within frail individuals, 52.4% were under the age of 65. In multivariable analysis, frailty was positively associated with age 70 or older (OR Z 3.44) and obesity (OR Z 2.66), and negatively associated with muscle mass (OR Z 0.77) and HF functional classes I (OR Z 0.14) or II (OR Z 0.29). Conclusion: Muscle mass seems to be an important predictor of frailty in patients with HF and should be taken into account when designing intervention plans that allow for reverting or modifying frailty and pre-frailty. Younger patients should be monitored for the presence and evolution of FP.

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“…HGS is, by itself, deemed as a useful outcome predictor in HF, being associated with incidence [36], hospitalization [37] and mortality [38].…”

Section: Discussionmentioning

confidence: 99%

Frailty phenotype and associated nutritional factors in a sample of Portuguese outpatients with heart failure

Valdiviesso

Azevedo

Moreira

et al. 2021

Nutrition, Metabolism and Cardiovascular Diseases

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“…There is a weak negative correlation between ECW and PA ( r = −0.367, p ≤ 0.0001) (Colin-Ramirez et al, 2006). PA was significantly lower in NYHA class III-IV than I-II in both systolic ( p = 0.04) and diastolic heart failure ( p = 0.01) (Castillo Martinez et al, 2007). The decreased PA, therefore, significantly was related to fluid overload ( p < 0.05) (Colin-Ramirez et al, 2006) and high risk of acute decompensation (Gulatava et al, 2021).…”

Section: Literature Reviewmentioning

confidence: 99%

“…Using the edema index combined with a multidisciplinary approach in acute heart failure patients can reduce rehospitalisation (3.8%) compared to a control group (18.9%) or a case management group (13.2%, p = 0.03; Liu et al, 2012). Moreover, abnormal fluid distribution together with low grip strength in men was independently related to all-cause mortality (hazard ratio 2.8; 95% CI: 1.25–6.4; p = 0.01), and this combination of parameters could suggest advanced heart failure regardless of gender (Castillo-Martínez et al, 2020). However, using BIA to examine prognostic values remain controversial.…”

Section: Literature Reviewmentioning

confidence: 99%

A Current Review of the Uses of Bioelectrical Impedance Analysis and Bioelectrical Impedance Vector Analysis in Acute and Chronic Heart Failure Patients: An Under-valued Resource?

Thanapholsart

Khan

Lee

2022

Biological Research For Nursing

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Background There is a need to detect and prevent fluid overload and malnutrition in heart failure. Bioelectrical impedance analysis and bioelectrical impedance vector analysis are medical instruments that can advance heart failure management by generating values of body composition and body water, assisting clinicians to detect fluid and nutritional status. However, there is a lack of evidence to summarise how they have been used among heart failure patients. Method A systematic search was conducted. Result Two hundred and four papers were screened. Forty-eight papers were reviewed, and 46 papers were included in this review. The literature shows that bioelectrical impedance analysis and bioelectrical impedance vector analysis were mostly used to assess fluid and nutritional status, together with diagnostic and prognostic values. Contraindication of using BIA and implications for practice are also demonstrated. Conclusion The findings suggest that bioelectrical impedance vector analysis is superior to bioelectrical impedance analysis when assessing hydration/nutritional status in heart failure. Assessing a patient using bioelectrical impedance analysis /bioelectrical impedance vector analysis, together with natriuretic peptide -heart failure biomarkers, increases the diagnostic accuracy of heart failure. Further studies are required to examine the cost effectiveness of using these instruments in clinical practice.

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“…Accumulating studies suggest that besides causing low physical performance and reduced cardiorespiratory fitness in older HF patients, reduced HGS in HF may also be a prognostic factor for poor survival 11,12 . However, previous studies evaluating the prognostic role of HGS in patients with HF retrieved inconsistent results 13–27 . Therefore, the aim of the study was to evaluate the association between HGS and prognosis of patients with HF by conducting a systematic review and meta‐analysis.…”

Section: Introductionmentioning

confidence: 99%

Handgrip strength and the prognosis of patients with heart failure: A meta‐analysis

Wang

Zhu

et al. 2023

Clinical Cardiology

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BackgroundReduced muscular strength is common in patients with heart failure (HF). The aim of the systematic review and meta‐analysis was to evaluate the association between handgrip strength (HGS) and prognosis of patients with HF.HypothesisReduced HGS may be a risk factor of poor prognosis of patients with HF.MethodsRelevant observational studies with longitudinal follow‐up were obtained by a comprehensive search of PubMed, Embase, Cochrane Library, and Web of Science databases. A random‐effects model was used to pool the results.ResultsFifteen studies involving 7350 patients with HF were included in the meta‐analysis. Pooled results showed that HF patients with lower HGS were associated with a higher risk of mortality during follow‐up (risk ratio [RR]: 2.00, 95% confidence interval [CI]: 1.55–2.58, p < .001; I2 = 0%). Subgroup analysis showed that the association was not significantly affected by characteristics such as study country, design, mean age of the patients, HF status (stable or advanced/acute), HF type (reduced or preserved ejection fraction), follow‐up duration, and quality score (p for subgroup difference all > 0.05). Further analysis showed that per 1 kgf decrease of HGS was associated with an 8% increased risk of mortality during follow‐up (RR: 1.08, 95% CI: 1.05–1.11, p < .001; I2 = 12%). Moreover, HF patients with lower HGS were also related to a higher risk of composite outcome of HF rehospitalization or mortality (RR: 1.67, 95% CI: 1.19–2.35, p = .003; I2 = 53%).ConclusionA low HGS may be associated with poor clinical outcomes of patients with HF.

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Abnormal fluid distribution and low handgrip strength index as predictors of mortality in Mexican patients with chronic heart failure

Cited by 9 publications

References 15 publications

Frailty phenotype and associated nutritional factors in a sample of Portuguese outpatients with heart failure

Frailty phenotype and associated nutritional factors in a sample of Portuguese outpatients with heart failure

A Current Review of the Uses of Bioelectrical Impedance Analysis and Bioelectrical Impedance Vector Analysis in Acute and Chronic Heart Failure Patients: An Under-valued Resource?

Handgrip strength and the prognosis of patients with heart failure: A meta‐analysis

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