Body composition changes in patients with systolic heart failure treated with beta blockers: A pilot study

Background: Cachexia is an independent risk factor for mortality in chronic heart failure (CHF). Beta blockers can reduce body energy expenditure and improve efficiency of substrate utilization. Aim: To assess the changes in body composition in non-cachectic patients with CHF treated with beta blockers. Methods: We prospectively followed 41 non-cachectic ambulatory CHF patients (mean age 67 ± 10 years, ejection fraction 37 ± 4%) treated with beta blockers for at least 6 months. Body composition was measured by bioimpedance. Results: At baseline 16/41 patients were treated with beta blockers while at the end of follow-up all patients received beta blockers (31/41 at full recommended dose). During follow up of 263 ± 106 days body weight (83.1 ± 16.7 vs. 83.0 ± 16.9 kg), body mass index (29.3 ± 5.5 vs. 29.3 ± 5.6) and total body water did not change (51.2 ± 6.4% vs. 51.0 ± 6.4%), while total body fat mass (27.4 ± 9.6 to 28.3 ± 10.2 kg, median change + 0.89 kg, p = 0.01) and percent of total body fat increased (32.3 ± 7.4% to 33.4 ± 7.5%, median change + 0.7%, p <0.001). New York Heart Association class and Minnesota Living with Heart Failure Questionnaire improved from 2.9 ± 0.4 and 48 ± 15 to 2.3 ± 0.6 and 32 ± 16, respectively (p <0.001 for both). Conclusion: In patients with CHF, treatment with beta blockers can increase total body fat mass and total body fat content.