Resting energy expenditure and the effects of muscle wasting in patients with chronic heart failure: Results from the studies investigating comorbidities aggravating heart failure (SICA-HF)

Matthias Tacke, Nicole Ebner, Michael Boschmann, Annett Jarius, Miroslava Valentova, Susann Fülster, Anja Sandek, Lutz Schomburg, Stefan D. Anker, Wolfram Doehner, Stephan von Haehling

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: Muscle wasting is common in patients with chronic heart failure (HF) and worsens functional status. Protein catabolism is characteristic of muscle wasting and contributes to resting energy expenditure (REE). Glucagonlike peptide 1 (GLP-1) is linked to REE in healthy individuals. We aimed to evaluate (1) whether REE is elevated in patients with HF with muscle wasting, and (2) whether basal GLP-1 levels are linked to REE in HF. Design: Cross-sectional study. Setting: Ambulatory patients with HF were recruited at the Charité Medical School, Campus Virchow-Klinikum, Berlin, Germany. Participants: A total of 166 patients with HF and 27 healthy controls participating in the Studies Investigating Co-morbidities Aggravating Heart Failure (SICA-HF) were enrolled. GLP-1 was measured in 55 of these patients. Measurements: Body composition was measured by dual-energy X-ray absorptiometry (DEXA). Muscle wasting was defined as appendicular lean mass of at least 2 SDs below values of a healthy young reference group. REE was measured by indirect calorimetry. GLP-1 was assessed by ELISA. Results: Thirty-four of 166 patients (mean age 67.4 ± 10.2 years, 77.7% male, New York Heart Association class 2.3 ± 0.6) presented with muscle wasting. REE in controls and patients with muscle wasting was significantly lower than in patients without muscle wasting (1579 ± 289 and 1532 ± 265 vs 1748 ± 359 kcal/d, P= .018 and P= .001, respectively). REE normalized for fat-free mass (FFM) using the ratio method (REE/FFM) and analysis of covariance was not different (P= .23 and .71, respectively). GLP-1 did not significantly correlate with REE (P= .49), even not after controlling for FFM using multivariable regression (P= .15). Conclusions: Differences in REE are attributable to lower FFM. GLP-1 does not relate to REE in patients with HF, possibly because of HF-related effects on REE.

Original languageEnglish
Pages (from-to)837-841
Number of pages5
JournalJournal of the American Medical Directors Association
Volume14
Issue number11
DOIs
Publication statusPublished - Nov 2013

Keywords

  • Glucagonlike peptide 1
  • Heart failure
  • Muscle wasting
  • Resting energy expenditure

ASJC Scopus subject areas

  • Medicine(all)
  • Nursing(all)
  • Health Policy

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