Heart failure was associated with significantly higher visceral adipose tissue and adverse muscle composition (36% vs 17%; P<0.001) compared to matched controls.
Case-Control (n=1,110)
Does body composition, specifically visceral adiposity and muscle fat infiltration, differ between patients with heart failure and BMI-matched controls?
Patients with heart failure exhibit significantly higher visceral adiposity and adverse muscle changes compared to BMI-matched controls, indicating that traditional anthropometric indexes underestimate body composition derangements in this population.
Absolute Event Rate: 36% vs 17%
p-value: p=<0.001
BACKGROUND Metabolic and musculoskeletal abnormalities in patients with heart failure (HF) may not be fully captured by body mass index. OBJECTIVES Body composition was studied in participants with HF and matched control subjects in the UK Biobank Imaging Study, and findings were compared among those with HF with reduced ejection fraction, HF with mildly reduced ejection fraction, and HF with preserved ejection fraction. METHODS Participants with HF and available ejection fraction (n = 185) were matched 1:5 to age-, sex-, and body mass index-matched control subjects (n = 925). Whole-body magnetic resonance-quantified visceral adipose tissue (VAT), abdominal subcutaneous adipose tissue, liver fat, thigh fat-free muscle volume (MV), and muscle fat infiltration (MFI) were assessed. Personalized z-scores adjusted for sex and body size were derived. Adverse muscle composition (AMC) was defined as low MV z-score and high MFI. Dual-energy x-ray absorptiometry was used to measure total fat and appendicular lean mass. RESULTS Compared with control subjects, HF participants had higher VAT (z-score = 0.46 ± 1.1 vs 0.07 ± 1.0; P < 0.001), MFI (8.4 ± 2.3% vs 7.6 ± 2.0%; P < 0.001), and AMC (36% vs 17%; P < 0.001) and lower MV (z-score = -0.7 ± 1.0 vs -0.1 ± 0.9; P < 0.001). Despite the muscle derangements identified by magnetic resonance imaging assessment, the prevalence of sarcopenia diagnosed using combined grip strength and dual-energy x-ray absorptiometry-derived lean mass parameters varied considerably depending on the criteria applied. Among HF subtypes, HF with mildly reduced ejection fraction showed the highest VAT and lowest MV, HF with preserved ejection fraction had greater fat and MFI, and HF with reduced ejection fraction had the greatest prevalence of AMC and the weakest grip strength. CONCLUSIONS Participants with HF showed higher VAT and adverse muscle changes, with weaker grip strength. Sarcopenia prevalence varied substantially across definitions, reflecting substantial variability and discrepancies among current sarcopenia definitions and criteria. Traditional anthropometric indexes underestimate the burden of body composition derangements in HF.
“Body composition profiling may provide incremental value for HF risk stratification, particularly in identifying early muscle deterioration and maladaptive fat distribution. Detecting phenotype-specific trajectories raises the possibility of tailoring therapeutic approaches according to underlyin...”
Published in JACC: Heart Failure, this research shows heart failure patients have more visceral fat and adverse muscle changes, suggesting body composition is a key prognostic factor.
Butler et al. (Sat,) conducted a case-control in Heart failure (n=1,110). Heart failure vs. Matched control subjects was evaluated on Adverse muscle composition (AMC) (p=<0.001). Heart failure was associated with significantly higher visceral adipose tissue and adverse muscle composition (36% vs 17%; P<0.001) compared to matched controls.