Prognostic role of phase angle in hospitalized patients with acute decompensated heart failure

被引:47
|
作者
Alves, Fernanda Donner [1 ,2 ]
Souza, Gabriela Correa [2 ,3 ]
Clausell, Nadine [1 ,2 ,4 ]
Biolo, Andreia [1 ,2 ,4 ]
机构
[1] Univ Fed Rio Grande do Sul, Fac Med, Postgrad Program Cardiovasc Sci, Ramiro Barcelos St 2400, BR-90035003 Porto Alegre, RS, Brazil
[2] Hosp Clin Porto Alegre, Ramiro Barcelos St 2350, BR-90035003 Porto Alegre, RS, Brazil
[3] Univ Fed Rio Grande do Sul, Fac Med, Dept Nutr, Ramiro Barcelos St 2400, BR-90035003 Porto Alegre, RS, Brazil
[4] Univ Fed Rio Grande do Sul, Fac Med, Dept Internal Med, Ramiro Barcelos St 2400, BR-90035003 Porto Alegre, RS, Brazil
关键词
Phase angle; Bioelectrical impedance; Heart failure; Prognostic; BIOELECTRICAL-IMPEDANCE ANALYSIS; BODY-MASS INDEX; OBESITY PARADOX; VECTOR ANALYSIS; MALNUTRITION; MORTALITY; DISEASE;
D O I
10.1016/j.clnu.2016.04.007
中图分类号
R15 [营养卫生、食品卫生]; TS201 [基础科学];
学科分类号
100403 ;
摘要
Background & aims: Patients with acute decompensated heart failure (ADHF) have exacerbation of symptoms and fluid retention, and high risk of re-hospitalizations and mortality. The aim of this study was to evaluate the role of phase angle at hospital admission as a prognostic marker of mortality in patients with ADHF. Methods: Patients hospitalized for ADHF, with left ventricular ejection fraction (LVEF) <45% and BOSTON criteria >= 8 points were included. The patients were evaluated at hospital admission (first 36 h) and then followed up for assessment of outcomes. Phase angle was measured with tetra polar bioelectrical impedance device. Mortality data was obtained from an average of 24 months after discharge, from the medical records of the hospital and outpatient or telephone contact with patients or family members. The best-discriminatory level of phase angle was selected based on the ROC curve for mortality. Results: seventy-one patients were included and the majority was male (63%), with a mean age of 61 +/- 12 years, ischemic etiology being the most prevalent (48%) and LVEF average of 26 +/- 8%. Mortality was 49% at an average of 24 months after hospital discharge. The average phase angle at hospital admission was 5.6 +/- 2, and lower values were associated with higher mortality. Survivors were compared to died patients in the risk factor variables for mortality. In multivariate analysis adjusting for age, LVEF and urea, phase angle <4.8 degrees was independently associated with increased mortality (HR 2.67; p = 0.015). Conclusions: Phase angle seems to be a prognostic marker in patients with ADHF independently of other known risk factors. (C) 2016 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.
引用
收藏
页码:1530 / 1534
页数:5
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