Article

Body fluid distribution in elderly subjects with congestive heart failure.

Department of Medical and Surgical Sciences, Division of Geriatrics, University of Padua, Padua, Italy.
Annals of clinical and laboratory science (Impact Factor: 0.88). 02/2004; 34(4):416-22.
Source: PubMed

ABSTRACT The aims of this study were to investigate body fluid changes in elderly patients suffering from congestive heart failure (CHF) and to identify the fluid measurement that best characterizes fluid overload states in CHF patients by comparison with normal hydration in the elderly. In a case-controlled experimental design, 72 elderly subjects (65-98 yr), 38 healthy and 34 with CHF, were studied. Total body water (TBW) and extracellular water (ECW) were determined by dilution methods; fat-free mass (FFM) and fat mass (FM) were determined by dual-energy X-ray absorptiometry (DEXA). In healthy subjects, the FFM hydration expressed as TBW% FFM (males 72.0 +/- 4.3 vs females 72.4 +/- 5.0%) and ECW% TBW (males 47.3 +/- 3.4 vs females 47.8 +/- 5.1) were similar in both genders. ECW in liters for FFM and for TBW (ECW% TBW), corrected for body weight, was greater in the group with CHF than in the control group, in both sexes. Among the relative fluid measures, only ECW% TBW [odds ratio (OR) 1.5] independently predicted fluid retention. Having an ECW% TBW greater than 50% corresponded to an OR of about 10. In conclusion, elderly patients suffering from CHF have a characteristic increase in body fluid levels, mainly affecting the extracellular compartment, and ECW% TBW is a useful indicator of fluid retention.

0 Bookmarks
 · 
97 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: Scaling left atrial (LA) size remains a challenge. An allometric model using body weight (BW) as scaling variable was recently proposed. We sought to examine the performance of this model in an obese population. A total of 266 consecutive overweight (110) and obese subjects (class I, II, and III obese 81, 47, and 28, respectively) were studied; 46 normal subjects with normal body mass index (BMI) served as controls. LA dimension (LAD) was scaled to BW, body surface area (BSA), BMI and height, respectively, using both isometric and allometric models. There were no significant differences in age, gender, or height among the five groups. The prevalence of comorbid conditions, wall thickness, E/E' and LAD measures increased significantly with increasing weight group (P < 0.01-0.001). With the isometric model, LAD corrected by BW, BSA, and BMI significantly but paradoxically decreased across the groups (P < 0.05-0.001). With the allometric model, LAD overcorrection by BM, BSA, and BMI was improved, but remained in the class III obese group. In contrast, scaling LAD to height showed significant and graded increase across the five groups in accordance with the increases of BMI, E/E' and the prevalence of comorbid conditions. All isometric models that correct LAD by BW or BW containing variables underestimate LA size in overweight and obese groups. The allometric model using height provides more consistent results and should be preferred to models using BW or BW containing variables in scaling LAD in obese population.
    Echocardiography 03/2011; 28(3):253-60. · 1.26 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: BACKGROUND: Exercise intolerance is the primary chronic symptom in patients with heart failure and preserved ejection fraction (HFPEF), the most common form of heart failure in older persons, and can result from abnormalities in cardiac, vascular, and skeletal muscle, which can be further worsened by physical deconditioning. However, it is unknown whether skeletal muscle abnormalities contribute to exercise intolerance in HFPEF patients. METHODS: This study evaluated lean body mass, peak exercise oxygen consumption (VO2), and the short physical performance battery in 60 older (69±7 years) HFPEF patients and 40 age-matched healthy controls. RESULTS: In HFPEF versus healthy controls, peak percent total lean mass (60.1±0.8% vs. 66.6±1.0%, p < .0001) and leg lean mass (57.9±0.9% vs. 63.7±1.1%, p = .0001) were significantly reduced. Peak VO2 was severely reduced including when indexed to leg lean mass (79.3±18.5 vs. 104.3±20.4ml/kg/min, p < .0001). Peak VO2 was correlated with percent total (r = .51) and leg lean mass (.52, both p < .0001). The slope of the relationship of peak VO2 with percent leg lean mass was markedly reduced in HFPEF (11±5ml/min) versus healthy controls (36±5ml/min; p < .001). Short physical performance battery was reduced (9.9±1.4 vs. 11.3±0.8) and correlated with peak VO2 and total and leg lean mass (all p < .001). CONCLUSION: Older HFPEF patients have significantly reduced percent total and leg lean mass and physical functional performance compared with healthy controls. The markedly decreased peak VO2 indexed to lean body mass in HFPEF versus healthy controls suggests that abnormalities in skeletal muscle perfusion and/or metabolism contribute to the severe exercise intolerance in older HFPEF patients.
    The Journals of Gerontology Series A Biological Sciences and Medical Sciences 03/2013; · 4.31 Impact Factor
  • European journal of clinical nutrition 07/2013; · 3.07 Impact Factor

Full-text

View
21 Downloads
Available from
May 21, 2014