Body composition changes assessment by bioelectrical impedance vectorial analysis in right heart failure and left heart failure

Background: Heart Failure (HF) patients developed changes in body composition as overhydration, muscle-skeletal wear and cardiac cachexia (CC). The possible factors involved in the development of CC in Right Heart Failure (RHF) patients are venous congestion, nutrient malabsorption. However, in HF, the overhydration obscure the loss of fat-free mass and difficult the body composition assessment. Bioelectrical impedance vectorial analysis (BIVA) is a method validated and used for hydration status and body composition assessment in HF. The aim of this study was to investigate the body compositions changes assessment by BIVA in the subjects with and without RHF and evaluate the risk factors for devolvement CC in HF subjects. Material and methods: Prospective cohort study. Subjects with confirmed diagnoses of HF, >18 years old without CC according to BIVA criteria were included. Subjects with congenital heart disease, cancer, HIV, and end-stage renal disease were excluded. Body composition was an assessment by BIVA. 288 HF patients were evaluated. RHF subjects had an impedance vector reduction (9.26 dR/H and -1.92 dXc/H, T2=14.9, D = 0.45, p<0.001), while subjects without RHF no-showed statistically significant changes (7.57 dR/H and 0.72 dXc/H, T2=3, D = 0.17, p = 0.200). The risks factors to development CC were age, RHF, phase angle < 5 degrees, total body water were risks factors while handgrip strength was a protector factor. Conclusions: RHF has greater disturbances in body composition and is a risk factor to development CC. (C) 2019 Elsevier Inc. All rights reserved.