Association of cardiac cachexia and atrial fibrillation in heart failure patients

Background: Cachexia is a common complication in patients with advanced heart failure (HF) associated with inflammatory response activation. Atrial fibrillation (AF) is the most frequent arrhythmia (26%), probably both exacerbate the cardiac cachexia (CC). Objectives: Evaluate the association of cardiac cachexia and atrial fibrillation in heart failure patients. Material and methods: In a case control study, CC was diagnosed by electrical bioimpedance with vectorial analysis (BIVA). Subjects with congenital heart disease, cancer, HIV, drug use and other causes than HF were excluded. Results: Of the 359 subjects analyzed (men: 52.9%) median age 65 years (55-74). Those with CC were older [72 (61-67)] vs. without [62 (52-70) years old, p < 0.01]. During follow-up 47.8% of subjects developed CC and 17.27% AF, this was significantly more frequent in cachectic patients CC (23% vs 12.11%, OR: 2.17, 95% CI: 1.19-4.01, p = 0.006). Subjects, with AF had lower left ventricular ejection fraction (25.49 +/- 12.96 vs. 32.01 +/- 15.02, p = 0.08), lower posterior wall thickness (10.03 +/- 2.12 vs. 11.00 +/- 2.47, p = 0.007), larger diameter of the left atrium (49.87 +/- 9.84 vs. 42.66 +/- 7.56, p < 0.001), and a higher prevalence of CC (85.42% vs. 69.77%, p = 0.028). The 50.58% of was in NYHA class I. In NYHA III, 22.95% were in AF vs. 12.10% with not AF (p = 0.027). Conclusion: The frequent coexistence of CC and AF as HF complications indicate greater severity of HF, regardless of its type of HF. (C) 2016 Published by Elsevier Ireland Ltd.