Body Composition and Incident Heart Failure in Older Adults: Results From 2 Prospective Cohorts
Year: 2021
Type: article
Study design: Observational Study
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.
Institutions: Albert Einstein College of Medicine, Montefiore Medical Center, University of Washington, University of Pittsburgh, Brigham and Women's Hospital, Harvard University, Beth Israel Deaconess Medical Center, VA Pittsburgh Healthcare System, University of Pittsburgh Medical Center, University of California Davis Medical Center, University of California, Davis, University of Maryland, Baltimore, University of California, San Francisco, San Francisco VA Health Care System
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,025
Awards: G1023702118, G125972088, CORONARY HEART DISEASE AND STROKE, CORONARY HEART DISEASE &STROKE IN PEOPLE AGED 65-84, DYNAMICS OF HEALTH,AGING, AND BODY COMPOSITION, CORONARY HEART DISEASE AND STROKE, Peripheral nerve decline: an underappreciated cause of injurious falls, DYNAMICS OF HEALTH, AGING, AND BODY COMPOSITION, CORONARY HEART DISEASE &STROKE IN PEOPLE AGED 65-84, CORONARY HEART DISEASE &STROKE IN THE ELDERLY, G270907595, G2800149121, HEALTH ABC--COORDINATING UNIT, G3220743633, G3256118428, G34347772, CHS research resources for the cardiovascular health of older adults, Non-esterified Fatty Acids and Cardiometabolic Disease in Older Adults, CENTRAL BLOOD ANALYSIS LABORATORY FOR CHS, Advanced Glycation Endproducts and Cardio-Renal Disease, G423252844, Training in Molecular Epidemiology: Linking Genes to Physical Function in Older Adults, G5479317095, G5909482378, CHS Events Follow-up Study, End of Life in the Very Old, CHS-Transition Phase, Exceptional Survival: Trajectories to Functional Aging (CHS All Stars), G870807107, G905887895, G945304896
OpenAlex ID: W4200160645