Examining cardiac cachexia in the thai heart failure patients

Abstract

Funding Acknowledgements Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Ministry of Public Health, Thailand Background Cardiac cachexia (CC) can occur in heart failure (HF)with weight and muscle loss. Screening for suspected CC and CC using Cachexia consensus, including CC symptoms, had not been examined among the Thai heart failure patients. Purpose To screen for suspected CC and CC in a HF out-patients setting in Thailand using the international cachexia consensus Method Anthropometric data, such as body weight, height, grip strength, skinfold thickness and waist circumferences, were collected. Bloods for haemoglobin, albumin, c-reactive protein (CRP), N-terminal pro-B-type natriuretic peptide (NT-proBNP) and serum osmolarity were collected. Bioelectrical impedance analysis (BIA) measurement using INBODY S10 was conducted. Participants were asked to complete questionnaires that were Simplified on Nutrition Appetite Questionnaire (SNAQ), Thirst Distress Scale-Heart Failure (TDS-HF) and Kansas City Cardiomyopathy Questionnaire. Results Thirty-eight participants were recruited. Of these two participants had confirmed and five with suspected CC and the remainder did not have CC (n=31). We analysed the data by comparing between two groups: 1) highly suggestive CC (confirmed CC and suspected CC), 2) non-CC. Anthropometric measurements, BIA parameters and fatigue were not significantly different between those with confirmed and suspected CC and those who have not have CC (P>0.05). CRP and NT-proBNP levels were higher in those with CC and suspected CC than those who have not have CC (CRP median 4.39 vs 1.25 and NT-proBNP median 3,889.00 vs 1,957.00, respectively). The SNAQ scores were significantly lower in highly suggestive CC than non-CC group (13.14±2.41 vs 15.07±2.28, p≤0.05), but TDS-HF scores were not significantly different (20.57±7.28 vs 19.74±9.54, p = 0.678). Quality of life scores were lower in highly suggestive CC group than non-CC group although it was not statistically significant (60.71±24.40 vs 66.67±24.06, p = 0.559). Phase angle positively correlated to SNAQ (r = 0.550, p = 0.015) and albumin (r = 0.622, p = 0.004). Conclusion This is the first pilot study in Thailand screening for CC. SNAQ with the support of phase angle can be a useful and affordable tool to simply screen for CC. NT-proBNP might be associated with the development of CC and poor disease prognosis.