Body composition, appetite-related hormones, adipocytokines, and heart failure in adult patients with congenital heart disease: A preliminary study

OBJECTIVES: To assess body composition and relationships among body composition, appetite-related hormones, adipocytokines, and heart failure (HF) in adult patients with congenital heart disease (CHD). PATIENTS: This prospective study enrolled 46 consecutive adult patients with CHD and 12 age-matched healthy controls. The patients and control subjects were divided into four groups: 13 patients with Fontan circulation (group A), 16 patients with cyanosis (group B), 17 patients who previously underwent biventricular repair (group C), and 12 age-matched healthy controls. DESIGN: Body composition was measured using InBody730, and levels of appetite-related hormones (ghrelin and leptin) and adipocytokines (leptin, interleukin-6, and tumor necrosis factor-α) were determined. Relationships of these measurements between severe HF, defined as New York Heart Association functional class III-IV and/or recent repeated unscheduled hospitalizations due to HF, were examined using univariate logistic analysis. RESULTS: Mean patient age was 32.1 ± 7.4 years. The skeletal muscle mass was significantly decreased in groups A and B compared with that in controls. Interestingly, ghrelin levels in groups A and B were also significantly lower than those in controls. Univariate logistic analysis revealed that ghrelin level, percent body fat, and pulse oximetric oxygen saturation were significantly associated with severe HF. CONCLUSIONS: Patients with Fontan circulation and those with cyanosis might be at a risk of sarcopenia. Despite the decreased skeletal muscle mass and increased body fat, ghrelin levels in these patients were decreased. These changes might have a negative impact on HF in these patients.