PREDICTORS OF WEIGHT LOSS IN PATIENTS WITH CHRONIC HEART FAILURE AND REDUSED LEFT VENTRICULAR EJECTION FRACTION

Kateryna Voitsekhovska,Leonid Voronkov

doi:10.21303/2504-5679.2019.00999

Abstract

Chronic heart failure (CHF) is a heterogeneous syndrome with a poor prognosis. Aim of the work – to define predictors of body weight (BW) loss in patients with CHF and a reduced left ventricular ejection fraction (LVEF). Materials and methods. 120 patients with stable CHF and LVEF ≤35 %, II-IV NYHA class were examined. Patients were divided into two groups according to the value of BW loss for 6 months: the first group - loss of BW <6 %, the second - ≥ 6 %. Results. Out of the 120 patients who were studied, a BW loss of ≥ 6 % occurred in 59 (49.2 %) patients. According to the results of binary logistic regression, predictors of BW loss of ≥6 % in patients with CHF and LVEF ≤ 35 % were: age, coronary heart disease, anaemia, and the number of hospitalizations over the last year. People with poorer quality of life, bigger number of points on the Beck depression scale and DEFS, with lower levels of physical activity and worse endothelium-dependent vasodilator response; higher sizes of the right atrium, right ventricle, and pulmonary artery systolic pressure, E / E '. Higher levels of C-reactive protein (CRP), uric acid are associated with a risk of losing BW≥6 %. Conclusions. Weight loss ≥ 6 % is observed in 49.2 % of patients with CHF and LVEF≤35 %. According to multivariate analysis, independent predictors of BW loss of ≥6 % in patients with CHF and LVEF≤35 % are age, CRP level, III-IV NYHA class, lower cholesterol levels, as well as lower rates of flow-dependent vasodilator response and hip circumference.

Highlights

Chronic heart failure (CHF) is a heterogeneous syndrome with a poor prognosis, independent predictors of which are neurohormonal activity disorders [1] and the development of cachexia
The relationship we found between the loss of body weight (BW) in patients with CHF and impaired function of the right heart is confirmed in previous studies [19, 20]
Weight loss ≥6 % is observed in 49.2 % of patients with CHF and left ventricular ejection fraction (LVEF)≤35 %

Summary

Introduction

Chronic heart failure (CHF) is a heterogeneous syndrome with a poor prognosis, independent predictors of which are neurohormonal activity disorders [1] and the development of cachexia. Cardiac cachexia is known to be a factor in reducing survival in CHF, regardless of other important variables, such as age, functional class, ejection fraction and physical capabilities [2, 3]. It was found that the mortality rate of patients with heart failure and progressive weight loss (BW) can reach 50 % within 18 months [6]. The pathophysiological mechanisms underlying the loss of BW in patients with CHF are not entirely understandable; a number of factors have been identified that lead to an imbalance of catabolic and anabolic processes [7]. The clinical characteristics of patients with CHF associated with their loss of BW have been little studied

Methods

Discussion

Conclusion