Perfil clínico, metabólico e de composição corporal de indivíduos com insuficiência cardíaca com e sem excesso de peso atendidos ambulatorialmente

Abstract

Heart failure (HF) is considered a clinically complex heterogeneous syndrome. One of the risk factors for HF is obesity, however, there is evidence that this disease in individuals diagnosed with HF may be a protective factor for unfavorable clinical outcomes, this phenomenon being called the “obesity paradox”. In this sense, a more in-depth knowledge of the body composition of these patients is necessary to better understand this phenomenon. The objective was to evaluate the clinical, metabolic profile and body composition of individuals with HF, with and without excess weight, treated on an outpatient basis. Methods. This study is of an observational, comparative nature of non-probabilistic convenience sampling that included data collected from 70 patients with HF treated at the Interprofessional Heart Failure Outpatient Clinic of Hospital Onofre Lopes. These patients were divided into two groups according to BMI category: Group 1: Not overweight (BMI <25.0kg/m2); Group 2: Overweight (BMI ≥ 25.0kg/m2). Data on the clinical and metabolic profile, as well as body composition, were obtained using bioelectrical impedance (BIA). Most of patients are individuals under the age of 55, male and have HF with reduced left ventricular fraction (HFrEF). There was a predominance of body mass index (BMI) indicative of overweight/obesity (65%) in the population. It was identified that triacylglycerol concentrations were higher in group 2 (p=0.003). The results of the BIA evaluation indicated lower resistance values (p = 0.010), however, higher values of body fat (p<0.001), fat-free mass (FFM) and FFM index (both p<0.001) in the group 2. The ratio of extracellular body water/total body water (ECW/TBW ratio) indicated that all participants in group 2 are in a state of severe overhydration (p = 0.014). It is concluded that obesity is a frequent comorbidity in individuals with HF treated on an outpatient basis, resulting in metabolic changes, such as hypertriglyceridemia, as well as body composition, with emphasis on greater body fat and FFM.

KEYWORDS: Heart failure. Body mass index. Electrical bioimpedance. Resistance. Fat-free dough.