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Measuring body composition in chronic heart failure: A comparison of methods
Author(s) -
UszkoLencer Nicole H.M.K.,
Bothmer Francien,
Pol Petra E.J.,
Schols Annemie M.W.J.
Publication year - 2006
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1016/j.ejheart.2005.07.007
Subject(s) - medicine , heart failure , composition (language) , cardiology , linguistics , philosophy
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 (Ht 2 / R ). On multiple regression next to Ht 2 / R , body weight was an independent predictor of FFM DEU ( r =0.95, SEE 2.5 kg, p <0.001; TBWdeu=0.528 Ht 2 / 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 FFM DXA should be considered. BIA is a suitable clinical alternative for diagnostic purposes.