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Increased estimated fat-free mass and fat mass associated with improved clinical outcome in heart failure

Israel Gotsman1,2, Andre Keren1,2, Offer Amir1

  • 1Heart Institute, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.

European Journal of Clinical Investigation
|July 22, 2021
PubMed

Insights

In heart failure (HF) patients, higher body mass, including fat-free and fat mass, is linked to better survival. Specific body composition metrics like fat-free mass index show a strong, graded association with improved outcomes.

Area of Science:

  • Cardiology
  • Metabolic Health
  • Clinical Nutrition

Background:

  • Body mass index (BMI) is linked to better heart failure (HF) outcomes, but specific body composition effects are unclear.
  • Limited research exists on how fat-free mass and fat mass impact mortality and hospitalization in chronic HF patients.
  • This study investigates the prognostic value of body composition in a large, real-world HF cohort.

Purpose of the Study:

  • To assess the impact of fat-free mass and fat mass on mortality and cardiovascular hospitalization in chronic heart failure (HF) patients.
  • To determine the association between various body composition indices and clinical outcomes in HF.
  • To provide insights into the role of body composition in managing heart failure.

Main Methods:

  • Utilized data from a large real-world cohort of 6328 patients with chronic heart failure (HF).
  • Calculated body composition indices including fat-free mass index, fat mass index, and percent body fat using specific formulas.
  • Employed Cox regression analysis and restricted cubic splines for survival analysis, adjusting for relevant clinical parameters.

Main Results:

  • Higher levels of body mass index, fat-free mass index, fat mass index, percent body fat, and waist circumference were associated with improved survival.
  • Fat-free mass index demonstrated the strongest graded association with survival, with the highest quartile showing significantly lower mortality.
  • The lowest quartile of all measured body composition indices was linked to a worse prognosis, including increased mortality and cardiovascular hospitalization.

Conclusions:

  • Body mass, encompassing both fat-free mass and fat mass, is a significant predictor of improved survival in heart failure (HF) patients.
  • Specific body composition metrics, particularly fat-free mass index, offer valuable prognostic information in HF management.
  • These findings highlight the importance of assessing body composition beyond BMI in patients with chronic heart failure.
Abstract

Keywords:
body mass indexfat-free massheart failureoutcome

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