factor in patients with chronic heart failure

article i nfo BackgroundandAim:Chronicheartfailure(CHF)isamajorcauseofmorbidityandmortality,andcardiaccachexia and sarcopenia are serious complications associated with weight loss and increased catabolism. Fat-free mass index (FFMI) is an indicator of resting energy expenditure and is used for the clinical diagnosis of sarcopenia. In the present study, we investigated the impact of sarcopenia, as evaluated by FFMI, on cardiac prognosis in patients with CHF. Methods and results: We calculated FFMI in 267 CHF patients who were prospectively followed until they died due to cardiac event, or until they were re-hospitalized. Fat-free mass (FFM) was estimated by the formula (FFM (kg)=7.38 + 0.02908 × urinary creatinine (mg/day)) andnormalized bythesquare of thepatient'sheight in meters to calculate FFMI. During the follow-up periods, there were 83 cardiac events, including 19 cardiac deaths. FFMI was lower in patients with cardiac events than in those without (17.0 kg/m 2 vs. 17.6 kg/m 2 , P = 0.045). Multivariate Cox hazard analysis revealed that decreased FFMI was associated with an unfavorable out- come (adjusted hazard ratio 0.68, 95% confidence interval 0.47-0.98). The patients were divided intotwo groups according to their median FFMI. The Kaplan-Meier analysis revealed that significantly higher cardiac event rate was observed in the low-FFMI group (log-rank test, P =0 .017). Conclusions: Decreased FFMI was associated with an unfavorable prognosis in patients with CHF.