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. 2017 Nov;4(4):448-457.
doi: 10.1002/ehf2.12209. Epub 2017 Sep 27.

Anorexia, functional capacity, and clinical outcome in patients with chronic heart failure: results from the Studies Investigating Co-morbidities Aggravating Heart Failure (SICA-HF)

Masakazu Saitoh  1 , Marcelo R Dos Santos  1   2 , Amir Emami  1 , Junichi Ishida  1 , Nicole Ebner  1 , Miroslava Valentova  1 , Tarek Bekfani  3 , Anja Sandek  1 , Mitja Lainscak  4 , Wolfram Doehner  5 , Stefan D Anker  1   6 , Stephan von Haehling  1
Affiliations

Anorexia, functional capacity, and clinical outcome in patients with chronic heart failure: results from the Studies Investigating Co-morbidities Aggravating Heart Failure (SICA-HF)

Masakazu Saitoh et al. ESC Heart Fail. 2017 Nov.

Abstract

Aims: We aimed to assess determinants of anorexia, that is loss of appetite in patients with heart failure (HF) and aimed to further elucidate the association between anorexia, functional capacity, and outcomes in affected patients.

Methods and results: We assessed anorexia status among 166 patients with HF (25 female, 66 ± 12 years) who participated in the Studies Investigating Co-morbidities Aggravating HF. Anorexia was assessed by a 6-point Likert scale (ranging from 0 to 5), wherein values ≥1 indicate anorexia. Functional capacity was assessed as peak oxygen uptake (peak VO2 ), 6 min walk test, and short physical performance battery test. A total of 57 patients (34%) reported any anorexia, and these patients showed lower values of peak VO2 , 6 min walk distance, and short physical performance battery score (all P < 0.05). Using multivariate analysis adjusting for clinically important factors, only high-sensitivity C-reactive protein [odds ratio (OR) 1.24, P = 0.04], use of loop diuretics (OR 5.76, P = 0.03), and the presence of cachexia (OR 2.53, P = 0.04) remained independent predictors of anorexia. A total of 22 patients (13%) died during a mean follow-up of 22.5 ± 5.1 months. Kaplan-Meier curves for cumulative survival showed that those patients with anorexia presented higher mortality (Log-rank test P = 0.03).

Conclusions: Inflammation, use of loop diuretics, and cachexia are associated with an increased likelihood of anorexia in patients with HF, and patients with anorexia showed impaired functional capacity and poor outcomes.

Keywords: Anorexia; Cachexia; Functional capacity; Heart failure.

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Figures

Figure 1
Figure 1
The prevalence of anorexia.
Figure 2
Figure 2
Impact of anorexia and cachexia on functional capacity in patients with heart failure. †P < 0.05 vs. no anorexia, ‡P < 0.05 vs. anorexia without cachexia. Peak VO2, peak oxygen consumption; SPPB, short physical performance battery.
Figure 3
Figure 3
Kaplan–Meier survival curve.
See this image and copyright information in PMC

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