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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

References

    1. Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Borden WB, Bravata DM, Dai S, Ford ES, Fox CS, Franco S, Fullerton HJ, Gillespie C, Hailpern SM, Heit JA, Howard VJ, Huffman MD, Kissela BM, Kittner SJ, Lackland DT, Lichtman JH, Lisabeth LD, Magid D, Marcus GM, Marelli A, Matchar DB, McGuire DK, Mohler ER, Moy CS, Mussolino ME, Nichol G, Paynter NP, Schreiner PJ, Sorlie PD, Stein J, Turan TN, Virani SS, Wong ND, Woo D, Turner MB, American Heart Association Statistics Committee and Stroke Statistics Subcommittee . Heart disease and stroke statistics–2013 update: a report from the American Heart Association. Circulation 2013; 127: e6–e245. - PMC - PubMed
    1. Sente T, Van Berendoncks AM, Hoymans VY, Vrints CJ. Adiponectin resistance in skeletal muscle: pathophysiological implications in chronic heart failure. J Cachexia Sarcopenia Muscle 2016; 7: 261–274. - PMC - PubMed
    1. Fülster S, Tacke M, Sandek A, Ebner N, Tschöpe C, Doehner W, Anker SD, von Haehling S. Muscle wasting in patients with chronic heart failure: results from the studies investigating co‐morbidities aggravating heart failure (SICA‐HF). Eur Heart J 2013; 34: 512–519. - PubMed
    1. Bekfani T, Pellicori P, Morris DA, Ebner N, Valentova M, Steinbeck L, Wachter R, Elsner S, Sliziuk V, Schefold JC, Sandek A, Doehner W, Cleland JG, Lainscak M, Anker SD, von Haehling S. Sarcopenia in patients with heart failure with preserved ejection fraction: impact on muscle strength, exercise capacity and quality of life. Int J Cardiol 2016; 222: 41–46. - PubMed
    1. Anker SD, Ponikowski P, Varney S, Chua TP, Clark AL, Webb‐Peploe KM, Harrington D, Kox WJ, Poole‐Wilson PA, Coats AJ. Wasting as independent risk factor for mortality in chronic heart failure. Lancet 1997; 349: 1050–1053. - PubMed

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