Key result
Sarcopenia or sarcopenic obesity linked to ~2.3-fold higher 12-month mortality and CHF readmission in elderly patients.
Why the study?
Diagnosing sarcopenia, sarcopenic obesity, and cachexia in elderly patients with chronic heart failure is challenging due to a lack of unified definitions and practical clinical algorithms. This study aimed to determine the frequency of pathological body composition phenotypes using bioelectrical impedance analysis and establish their relationship with adverse outcomes.
Does the presence of sarcopenic obesity or sarcopenia identified via bioimpedance analysis increase the risk of all-cause mortality and recurrent hospitalizations in elderly patients with decompensated chronic heart failure?
Observational (n=250)
No
Does the presence of sarcopenic obesity or sarcopenia identified via bioimpedance analysis increase the risk of all-cause mortality and recurrent hospitalizations in elderly patients with decompensated chronic heart failure?
In elderly patients hospitalized for decompensated chronic heart failure, bioimpedance analysis effectively identifies sarcopenia and sarcopenic obesity, which are independently associated with more than double the risk of 12-month mortality and heart failure rehospitalization.
Associated with higher risk in elderly CHF; hypothesis-generating and requires prospective validation before practice change.
Introduction. Body structure abnormalities such as sarcopenia, sarcopenic obesity, and cachexia can play a key role in the development and progression of chronic heart failure (CHF). However, diagnosis of these conditions is challenging due to the lack of unified approaches to their definition. Previously proposed algorithms for identifying cachexia and sarcopenia in elderly patients are difficult to apply in clinical practice. Therefore, noninvasive body composition assessment in elderly patients with CHF, such as bioelectrical impedance analysis (BIA), is becoming relevant. Aim: To determine the most frequent pathological phenotypes of body composition in elderly patients with CHF and establish their relationship with adverse disease outcomes. Material and Methods. The prospective observational study included 250 patients (median age 83.0 [77.0-86.0] years) consecutively hospitalized in a multidisciplinary hospital for CHF decompensated. To assess body composition, a bioinformatics analyzer (BIA) (ABC-01 Medass analyzer, Russia) was performed on days 5-7 of hospitalization. According to the results, patients were divided into five body composition phenotypes: normal, obese, sarcopenic obesity (according to ESPEN/EASO 2022 criteria), sarcopenia (according to EWGSOP2 criteria), and cachexia (according to Ballyuzek MF, 2015 criteria). To study the prognostic significance of body composition abnormalities, a composite endpoint was assessed, including all-cause mortality and recurrent hospitalizations for CHF within 12 months. Results. When analyzing body composition phenotypes according to BIA in elderly patients with CHF, the most common phenotype was obesity (48.0%, n = 120), less common were sarcopenic obesity (24.0%, n = 60), sarcopenia (6.0%, n = 15), and cachexia (2.0%, n = 5). Depending on body composition phenotypes, patients did not differ in left ventricular ejection fraction; a predominantly preserved ejection fraction was observed in all groups. Patients with cachexia, sarcopenia, and sarcopenic obesity were characterized by lower exercise tolerance, NYHA functional class III-IV, and a more severe stage of circulatory failure. The presence of sarcopenic obesity or sarcopenia increases the risk of the combined primary endpoint by 2.3 times (OR 2.3; 95% CI 1.2-4.4, p < 0.05) and in-hospital mortality by 2.9 times (OR 2.9; 95% CI 1.4-6.4, p < 0.05). Conclusion. Muscle mass has a protective effect in elderly patients with CHF, whereas sarcopenic obesity and sarcopenia are associated with worse outcomes. Bioimpedance analysis of body composition is relatively simple and accurate in this patient cohort and allows for the detection of dual pathology in patients with CHF: hyperhydration typical of CHF decompensation and associated signs of progressive sarcopenia and cellular dysfunction.
No takes yet. Share an insight, caveat, or question.
Kobalava et al. (2026) conducted an observational in Decompensated chronic heart failure (n=250). Sarcopenic obesity or sarcopenia identified via bioelectrical impedance analysis vs. Normal or non-sarcopenic body composition phenotypes was evaluated on Composite of all-cause mortality and recurrent hospitalizations for chronic heart failure within 12 months (OR 2.3, 95% CI 1.2-4.4, p=<0.05). Sarcopenic obesity or sarcopenia in elderly CHF patients increased the 12-month risk of all-cause mortality and recurrent CHF hospitalization (OR 2.3; 95% CI 1.2-4.4; p<0.05).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: