Association Between the Distribution of Body Fluid and Mortality in Heart Failure patients

Abstract

Background: Patients with heart failure (HF) are characterized by fluid retention. Bioelectrical impedance vector analysis (BIVA) allows the assessment of body composition, especially the distribution of body fluid in extracellular water (ECW), third space and total body water (TBW). Fluid overload in other populations has been identified as a predictor of mortality. However, few studies have analysed the effect of this distribution on the mortality of patients with HF. Objective: To evaluate if there is an association between the distribution of body fluid and mortality in heart failure patientes. Methods: Prospective cohort study. Patients older than 18 years old with a diagnosis of stable HF were included. Patients with cancer, myocardial infarction less than 6 months and decompensated HF were excluded. Body composition was evaluated using BIVA. Results: A total of 130 patients were enrolled in the study, mean age 65.96 ± 14.85 years, older subjects survived lesser (82 ± 7.53 vs 65.61 ± 14.57, p = 0.007) than those who survived. When body composition was assessed, subjects who died reported higher total body water (AEC: 27.73 ± 2.61 vs 24.01 ± 2.63, p = 0.001), impedance Index (0.86 ± 0.04 vs. 0.81 ± 0.05, p = 0.016), third space (0.76-0.09) vs 0.21 (0.31-0.877), lower hand strength levels (18.33 ± 10.03 vs 26.87 ± 8.88, p = 0.046) and phase angle (3.68 ± 1.47 vs 5.46 ± 1.45, p = 0.004) than those who survived. Conclusions: In patients with HF, the amount and distribution of body fluid is a marker of mortality risk.