Real-world assessment of body composition in patients hospitalized for acute heart failure: A prospective cohort study

Heart failure and cardiac decompensation, often leading to recurrent hospitalizations, significantly impair quality of life and life expectancy. Monitoring hydration status is crucial in managing these patients. Although body impedance analysis (BIA) is a simple, cost-effective, and noninvasive method, its clinical application remains underutilized worldwide. Given its potential to improve therapy management, this study aimed to evaluate the feasibility of repetitive BIA measurements in patients hospitalized for acute heart failure in a real-world clinical setting. Thirty two patients hospitalized for acute heart failure were enrolled in this prospective cohort study between June 8, 2021, and May 16, 2022. Repetitive measurements of body weight and composition were performed on admission, day 3, and day 6. All measurements were performed by previously untrained medical staff after a 10-minute introduction. We observed a significant decrease in body weight by 2.02 kg (P < .001) within the first 3 days under diuretic therapy, which corresponded to a significant loss of body water (-1.51 kg; P = .013) and a slight loss of body fat (-1.41 kg; P = .002). Subsequent measurements on day 6 showed variable results. An additional loss of body weight (-1.63 kg; P ≤ 0.001) was mainly driven by a reduction of fat (-1.01 kg; P = .040) and body cell mass (-1.91 kg; P = .027). Only few patients benefited from further intensified diuretic therapy with a subsequent loss of body water (-0.51 kg; P = .580). BIA provides essential data on body composition, which cannot be assessed by simple weight measurements as these may be altered by simultaneous changes in fat or body cell mass. BIA measurements are feasible and easy to learn and should be implemented in routine cardiovascular care.