Beyond BMI: Body Composition Patterns Emerge in HF

Key Points:

• A study published in JACC: Heart Failure found that participants with heart failure (HF) had higher visceral adipose tissue (VAT), more adverse muscle changes, and weaker grip strength compared to matched controls.
• The research, involving 185 UK Biobank participants with HF and 925 controls, showed significant differences in body composition measures such as VAT, muscle fat infiltration (MFI), muscle volume (MV), and adverse muscle composition (AMC) across HF phenotypes.
• Participants with HF with mildly reduced ejection fraction (HFmrEF) exhibited the highest VAT and lowest muscle volume, those with HF with preserved ejection fraction (HFpEF) had greater fat and MFI, while those with HF with reduced ejection fraction (HFrEF) had the highest AMC prevalence and weakest grip strength.
• Sarcopenia prevalence varied widely depending on diagnostic criteria, with traditional definitions potentially underdetecting muscle abnormalities; BMI was noted as an insufficient measure to capture metabolic and musculoskeletal anomalies in HF patients.
• The authors suggest that detailed body composition profiling could improve HF risk stratification and enable phenotype-specific therapeutic strategies by identifying early muscle deterioration and maladaptive fat distribution.