© 2006 European Society of Cardiology
Measuring body composition in chronic heart failure: A comparison of methods
a Department of Respiratory Medicine Department of Cardiology, University Hospital Maastricht The Netherlands
b Reinier de Graaf gasthuis Delft, The Netherlands
* Corresponding author. E-mail address: n.lencer{at}cardio.azm.nl
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Abstract |
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Aims: Fat-free mass (FFM) is increasingly recognized as a systemic marker of disease severity in chronic organ failure and is an important target for physiologic and pharmacologic interventions to improve functional status. The aim of this study was therefore to evaluate two clinical methods to assess FFM in patients with chronic heart failure (CHF) using deuterium dilution (DEU) as reference and bromide dilution to assess the ratio between intracellular (ICW) and extracellular water (ECW) as potential confounder.
Methods: Body composition was measured with dual-energy X-ray absorptiometry (DXA), bioelectrical impedance analysis (BIA) and DEU in 22 stable patients from our heart failure outpatient clinic and 24 healthy age matched controls.
Results: FFM values measured by DXA and DEU in patients (r=0.92, SEE: 3.1 kg) and controls (r=0.99, SEE: 1.3 kg) were strongly related. In both patients and controls, the inter method difference increased with higher values of FFM (DXA overestimating DEU). The ICW/ECW ratio was within the normal range and comparable between the groups. In patients, a highly significant correlation coefficient was found (r=0.93, SEE 2.1 p=0.01) between total body water (DEU) and height squared/resistance (Ht2/R). On multiple regression next to Ht2/R, body weight was an independent predictor of FFMDEU (r=0.95, SEE 2.5 kg, p<0.001; TBWdeu=0.528 Ht2/R+(0.182 weight)+8.277).
Conclusion: DXA and DEU are appropriate and interchangeable laboratory methods for assessment of FFM in clinically stable heart failure patients, however, overestimation of FFMDXA should be considered. BIA is a suitable clinical alternative for diagnostic purposes.
Key Words: Body composition • Chronic heart failure • Bioelectrical impedance analysis
Received October 27, 2004; Revised April 4, 2005; Accepted July 12, 2005
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