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    Body Composition and Incident Heart Failure in Older Adults: Results From 2 Prospective Cohorts.

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    Author
    Zhang, Lili
    Bartz, Traci M
    Santanasto, Adam
    Djoussé, Luc
    Mukamal, Kenneth J
    Forman, Daniel E
    Hirsch, Calvin H
    Newman, Anne B
    Gottdiener, John S
    Kizer, Jorge R
    Date
    2021-12-20
    Journal
    Journal of the American Heart Association
    Publisher
    Wiley-Blackwell
    Type
    Article
    
    Metadata
    Show full item record
    See at
    https://doi.org/10.1161/JAHA.121.023707
    Abstract
    Background Aging is associated with central fat redistribution and skeletal muscle decline, yet the relationships of tissue compartments with heart failure (HF) remain incompletely characterized. We assessed the contribution of body composition to incident HF in elders. Methods and Results Participants from 2 older cohorts who completed dual-energy X-ray absorptiometry (DEXA) and, in one cohort, computed tomography were included. We evaluated associations with incident HF for DEXA principal components (PCs) and total lean, appendicular lean, total fat and trunk fat mass; and for computed tomography measures of abdominal visceral and subcutaneous fat, thigh muscle, intermuscular fat area and thigh muscle density. DEXA analysis included 3621, and computed tomography analysis 2332 participants. During median follow-up of 11.8 years, 927 participants developed HF. DEXA principal components showed no relationship with HF. After adjustment for height, weight, and cardiovascular risk factors, total lean mass was near significantly associated with higher HF (hazard ratio [HR], 1.25 per SD [1.00-1.56]), whereas total fat mass and thigh muscle density were significantly related to lower HF (HR, 0.82 [0.68-0.99] and HR, 0.87 [0.78-0.97], respectively). Patterns were similar for HF subtypes. The relationships with HF for total lean and fat mass were attenuated after adjusting for intercurrent atrial fibrillation or excluding high natriuretic peptide levels. Conclusions Total lean mass was positively associated, while total fat mass and thigh muscle density were inversely associated, with incident HF. These findings highlight the limitations of DEXA for assessment of HF risk in elders and support the preeminence of computed tomography-measured skeletal muscle quality over mass as a determinant of HF incidence.
    Keyword
    adiposity
    body composition
    heart failure
    skeletal muscle
    Identifier to cite or link to this item
    http://hdl.handle.net/10713/17561
    ae974a485f413a2113503eed53cd6c53
    10.1161/JAHA.121.023707
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