Regression of Body Compositional Abnormalities of Heart Failure after Intracardiac Operations

Abstract

Alterations in body composition are present in patients with heart disease and congestive heart failure, and additional changes occur acutely after corrective surgery. The reversibility and time course of reversion to normal body composition have not been demonstrated. Nine patients were studied preoperatively and 2 to 4 weeks and 6 to 12 mo postoperatively. Measurements were made, using the isotope-dilution technic, of the volumes of total body water, extracellular water, plasma, and red cells, and of the amounts of total exchangeable sodium and potassium. Values were derived for body fat, indices of body cell mass, and the intracellular and extracellular distribution of water and potassium. Significant changes ( P < 0.05) occurring 2 to 4 weeks after operation were increased in total body water (8.2%), intracellular water (15.0%), exchangeable sodium (7.1%), and intracellular potassium content (7.7%), and decrease in body weight (4.6%) and body fat (21.6%); 6 to 12 mo postoperatively there was increase in exchangeable potassium (6.8%), body weight (7.8%), and decrease in exchangeable sodium (16.1%), extracellular fluid (7.8%), plasma (8.0%), and the ratio of exchangeable sodium to exchangeable potassium (23.6%). Late postoperative values were similar to predicted normal values and indicate that postoperative recovery from valvular replacement in these patients is accompanied by resolution of most of the body compositional abnormalities of heart failure.