Kateryna Voitsekhovska, Leonid Voronkov


Chronic heart failure (CHF) is a heterogeneous syndrome with a poor prognosis.

Aim of the work – to define predictors of body weight (BW) loss in patients with CHF and a reduced left ventricular ejection fraction (LVEF).

Materials and methods. 120 patients with stable CHF and LVEF ≤35 %, II-IV NYHA class were examined. Patients were divided into two groups according to the value of BW loss for 6 months: the first group - loss of BW <6 %, the second - ≥ 6 %.

Results. Out of the 120 patients who were studied, a BW loss of ≥ 6 % occurred in 59 (49.2 %) patients. According to the results of binary logistic regression, predictors of BW loss of ≥6 % in patients with CHF and LVEF ≤ 35 % were: age, coronary heart disease, anaemia, and the number of hospitalizations over the last year. People with poorer quality of life, bigger number of points on the Beck depression scale and DEFS, with lower levels of physical activity and worse endothelium-dependent vasodilator response; higher sizes of the right atrium, right ventricle, and pulmonary artery systolic pressure, E / E '. Higher levels of C-reactive protein (CRP), uric acid are associated with a risk of losing BW≥6 %.

Conclusions. Weight loss ≥ 6 % is observed in 49.2 % of patients with CHF and LVEF≤35 %. According to multivariate analysis, independent predictors of BW loss of ≥6 % in patients with CHF and LVEF≤35 % are age, CRP level, III-IV NYHA class, lower cholesterol levels, as well as lower rates of flow-dependent vasodilator response and hip circumference.


chronic heart failure; weight loss; cardiac cachexia; predictors

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Dube, P., Weber, K. T., Weber, K. T. (2011). Congestive Heart Failure: Pathophysiologic Consequences of Neurohormonal Activation and the Potential for Recovery: Part II. The American Journal of the Medical Sciences, 342 (6), 503–506. doi:

Okoshi, M. P., Romeiro, F. G., Paiva, S. A., Okoshi, K. (2013). Heart failure induced cachexia. Arquivos Brasileiros De Cardiologia, 100, 476–482. doi:

Stewart Coats, A. J., Shewan, L. G. (2017). A comparison of research into cachexia, wasting and related skeletal muscle syndromes in three chronic disease areas. International Journal of Cardiology, 235, 33–36. doi:

Anker, S. D., Negassa, A., Coats, A. J., Afzal, R., Poole-Wilson, P. A., Cohn, J. N., Yusuf, S. (2003). Prognostic importance of weight loss in chronic heart failure and the effect of treatment with angiotensin-converting-enzyme inhibitors: an observational study. The Lancet, 361 (9363), 1077–1083. doi:

Song, E. K., Lee, Y., Moser, D. K., Dekker, R. L., Kang, S.-M., Lennie, T. A. (2014). The Link of Unintentional Weight Loss to Cardiac Event–Free Survival in Patients With Heart Failure. The Journal of Cardiovascular Nursing, 29 (5), 439–447. doi:

Von Haehling, S., Anker, S. D. (2010). Cachexia as a major underestimated and unmet medical need: facts and numbers. Journal of Cachexia, Sarcopenia and Muscle, 1 (1), 1–5. doi:

Szabó, T., Postrach, E., Mähler, A., Kung, T., Turhan, G., von Haehling, S. et. al. (2013). Increased catabolic activity in adipose tissue of patients with chronic heart failure. European Journal of Heart Failure, 15 (10), 1131–1137. doi:

Ponikowski, P., Voors, A. A., Anker, S. D., Bueno, H., Cleland, J. G. F., Coats, A. J. S. et. al. (2016). ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). European Heart Journal, 37 (27), 2129–2200. doi:

Voronkov, L. H. et. al. (Eds.) (2017). Rekomendatsii Asotsiatsii kardiolohiv Ukrainy z diahnostyky ta likuvannia khronichnoi sertsevoi nedostatnosti. Kyiv, 66.

Kovalenko, V. M., Ivaniv, Yu. A.; Kovalenko, V. M. et. al. (Eds.) (2015). Rekomendatsii robochoi hrupy z funktsionalnoi diahnostyky asotsiatsii kardiolohiv Ukrainy i Vseukrainskoi asotsiatsii fakhivtsiv z ekhokardiohrafii. Kyiv.

Stevens, L. A., Coresh, J., Greene, T., Levey, A. S. (2006). Assessing Kidney Function – Measured and Estimated Glomerular Filtration Rate. New England Journal of Medicine, 354 (23), 2473–2483. doi:

Voronkov, L. G., Parascheniuk, L. P. (2010). Kachestvo zhizni pri serdechnoi nedostatochnosti: aktualnye aspekty. Serceva nedostatnіst, 2, 12–16.

Gilarevsky, S. R., Orlov, V. A., Bendeliani, N. G., Hamaganova, L. K., Sycheva, E. Y. (2001). A Study of life quality in patients with chronic heart failure: the contemporary status. Russian Journal of Cardiology, 3, 58–72.

Vatutin, N. T., Kalinkina, N. V., Каrtamysheva, Ye. V., Khristichenko, M. A., Yeshchenko, Ye. V. (2013). Depressive disorders and chronic heart failure. Ukrainian Journal of Cardiology, 3, 117–124.

Tiesinga, L. J., Dassen, T. W. N., Halfens, R. J. G. (1998). DUFS and DEFS: development, reliability and validity of the Dutch Fatigue Scale and the Dutch Exertion Fatigue Scale. International Journal of Nursing Studies, 35 (1-2), 115–123. doi:

Voronkov, L. G., Shkurat, I. A., Besaga, Е. M. (2005). Endothelium-dependent vasodilatation and its prognostic value in patients with chronic heart failure and left ventricular systolic dysfunction. Ukrainian Journal of Cardiology, 6, 86–90.

Cavey, J. (2011). Cardiac Cachexia. The Journal for Nurse Practitioners, 7 (7), 578–581. doi:

Yamada, M., Nishiguchi, S., Fukutani, N., Tanigawa, T., Yukutake, T., Kayama, H. et. al. (2013). Prevalence of Sarcopenia in Community-Dwelling Japanese Older Adults. Journal of the American Medical Directors Association, 14 (12), 911–915. doi:

Melenovsky, V., Kotrc, M., Borlaug, B. A., Marek, T., Kovar, J., Malek, I., Kautzner, J. (2013). Relationships Between Right Ventricular Function, Body Composition, and Prognosis in Advanced Heart Failure. Journal of the American College of Cardiology, 62 (18), 1660–1670. doi:

Valentova, M., von Haehling, S., Krause, C., Ebner, N., Steinbeck, L., Cramer, L. et. al. (2013). Cardiac cachexia is associated with right ventricular failure and liver dysfunction. International Journal of Cardiology, 169 (3), 219–224. doi:

Valentova, M., von Haehling, S., Bauditz, J., Doehner, W., Ebner, N., Bekfani, T. et. al. (2016). Intestinal congestion and right ventricular dysfunction: a link with appetite loss, inflammation, and cachexia in chronic heart failure. European Heart Journal, 37 (21), 1684–1691. doi:

Liu, X., Yin, S., Chen, Y., Wu, Y., Zheng, W., Dong, H. et. al. (2018). LPS‑induced proinflammatory cytokine expression in human airway epithelial cells and macrophages via NF‑κB, STAT3 or AP‑1 activation. Molecular Medicine Reports, 17 (4), 5484–5491. doi:

Shrivastava, A. K., Singh, H. V., Raizada, A., Singh, S. K. (2015). C-reactive protein, inflammation and coronary heart disease. The Egyptian Heart Journal, 67 (2), 89–97. doi:

Ridker, P. M., Rifai, N., Rose, L., Buring, J. E., Cook, N. R. (2002). Comparison of C-Reactive Protein and Low-Density Lipoprotein Cholesterol Levels in the Prediction of First Cardiovascular Events. New England Journal of Medicine, 347 (20), 1557–1565. doi:

Kalogeropoulos, A., Georgiopoulou, V., Psaty, B. M., Rodondi, N., Smith, A. L., Harrison, D. G. et. al. (2010). Inflammatory Markers and Incident Heart Failure Risk in Older Adults: The Health, Aging, and Body Composition Study. Journal of the American College of Cardiology, 55 (19), 2129–2137. doi:

Anand, I. S., Latini, R., Florea, V. G., Kuskowski, M. A., Rector, T., Masson, S. et. al. (2005). C-Reactive Protein in Heart Failure Prognostic Value and the Effect of Valsartan. Circulation, 112 (10), 1428–1434. doi:

Sproston, N. R., Ashworth, J. J. (2018). Role of C-Reactive Protein at Sites of Inflammation and Infection. Frontiers in Immunology, 9. doi:

Eklund, C. M. (2009). Chapter 5 Proinflammatory cytokines in CRP baseline regulation. Advances in Clinical Chemistry, 48, 111–136. doi:

Yamauchi-Takihara, K., Ihara, Y., Ogata, A., Yoshizaki, K., Azuma, J., Kishimoto, T. (1995). Hypoxic Stress Induces Cardiac Myocyte–Derived Interleukin-6. Circulation, 91 (5), 1520–1524. doi:

Deokar, S. A., Dandekar, S. P., Shinde, G. A., Prabhu, S. S., Patawardhan, M. (2018). Role of serum interleukin-6 in heart failure. International Journal of Advances in Medicine, 5 (4), 936–940. doi:

Sproston, N. R., El Mohtadi, M., Slevin, M., Gilmore, W., Ashworth, J. J. (2018). The Effect of C-Reactive Protein Isoforms on Nitric Oxide Production by U937 Monocytes/Macrophages. Frontiers in Immunology, 9. doi:

Pasceri, V., Willerson, J. T., Yeh, E. T. H. (2000). Direct Proinflammatory Effect of C-Reactive Protein on Human Endothelial Cells. Circulation, 102 (18), 2165–2168. doi:

Fedele, F., Mancone, M., Chilian, W. M., Severino, P., Canali, E., Logan, S. et. al. (2013). Role of genetic polymorphisms of ion channels in the pathophysiology of coronary microvascular dysfunction and ischemic heart disease. Basic Research in Cardiology, 108 (6). doi:

Park, K.-H., Park, W. J. (2015). Endothelial Dysfunction: Clinical Implications in Cardiovascular Disease and Therapeutic Approaches. Journal of Korean Medical Science, 30 (9), 1213–1225. doi:

Landmesser, U., Spiekermann, S., Dikalov, S., Tatge, H., Wilke, R., Kohler, C. et. al. (2002). Vascular Oxidative Stress and Endothelial Dysfunction in Patients With Chronic Heart Failure. Circulation, 106 (24), 3073–3078. doi:

Timmerman, K. L., Volpi, E. (2013). Endothelial function and the regulation of muscle protein anabolism in older adults. Nutrition, Metabolism and Cardiovascular Diseases, 23, S44–S50. doi:

Dos Santos, M. R., Saitoh, M., Ebner, N., Valentova, M., Konishi, M., Ishida, J. et. al. (2017). Sarcopenia and Endothelial Function in Patients With Chronic Heart Failure: Results From the Studies Investigating Comorbidities Aggravating Heart Failure (SICA-HF). Journal of the American Medical Directors Association, 18 (3), 240–245. doi:

Zhao, Q., Li, J., Yang, J., Li, R. (2017). Association of total cholesterol and HDL-C levels and outcome in coronary heart disease patients with heart failure. Medicine, 96 (9), e6094. doi:

Azhar, G., Wei, J. Y. (2013). New Approaches to Treating Cardiac Cachexia in the Older Patient. Current Cardiovascular Risk Reports, 7 (6), 480–484. doi:

Wright, F. L., Green, J., Reeves, G., Beral, V., Cairns, B. J. (2015). Validity over time of self-reported anthropometric variables during follow-up of a large cohort of UK women. BMC Medical Research Methodology, 15 (1). doi:



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