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Functional Class Deterioration Associated with Changes in Body Weight,Muscle Strength and Body Water in Chronic Stable Heart Failure Patients

Cira Santillán-Díaz, Arturo Orea-Tejeda, Lilia Castillo-Martínez, Candace Keirns-Davis, Dulce Gabriela González-Islas, Wendy Daniella Rodríguez-García, Efraín Alcalá-Dávila and Fernando Dávila-Radilla

Background: Over the course of heart failure, clinical manifestations can be explained by changes in body composition, mainly as decrease in body weight and lean body mass and body water imbalance. The aim of this study was to examine the association of changes in weight, handgrip strength and total body water with clinical status in patients with chronic stable heart failure.

Methods: In a longitudinal cohort prospective study 222 consecutive patients (55.6% men, median age 67 years) were included. They underwent measurements at the beginning and after 6 months. Weight, height, hip circumference, waist circumference, handgrip strength, total body water and extracellular water (using Bioelectrical Impedance) were evaluated.

Results: Three different types of change combinations were more frequently observed in patients with functional class deterioration: a) weight loss, increase in total body water and extracellular water and decreased handgrip strength (p=0.049), b) increased weight, total body water and extracellular water and decreased handgrip strength (p=0.01) and c) unchanged weight, decreased total body water and extracellular water and decreased handgrip strength (p=0.01).

Conclusions: Handgrip strength, total body water and extracellular water were better predictors of clinical deterioration than weight alone as indicators of functional class deterioration and should be evaluated in heart failure patients.