Postdoctoral Fellowship: Seongkum Heo: Body Fat, Nutrition and Outcomes in Patients with Heart Failure

Cardiac cachexia is an independent risk factor or morbidity and mortality in patients with heart failure (HF). In contrast, obesity was recently reported to be associated with decreased risk of morbidity and mortality. The finding that overweight and obese patients with HF have surprisingly better outcomes is in contrast to our current understanding of the relationships between obesity and HF, and conflicts with the recommendation that these individuals should lose weight. The biobehavioral mechanisms underlying differences in outcomes between these groups of patients are not known. The purpose of this study is to examine the relationship among body fat and distribution, nutritional intake, and event-free survival in patients with HF. The specific aims are: (1) to determine the relationship between body fat content and distribution, and six-month event-free survival in four groups (underweight, normal weight, overweight, and obese) of patients with HF of ischemic origin: and (2) to determine the effects of nutritional intake on six-month event-free survival. A total of 300 patients with HF will be recruited. Body fat content and distribution, and nutritional intake will be collected using dual energy absorptiometry, anthropometries, bioimpedance analysis and self-reported food diaries. Event-free survival will be collected using a combination of medical record and hospital administrative database review, and patient and family interviews. Survival analysis with Cox proportional hazards modeling will be used to test the hypotheses. Examination of the interactive effects among body fat content and distribution, and nutritional intake will provide an understanding of the biobehavioral mechanisms underlying improved event-free survival observed in overweight and obese patients with HF. This will assist with developing new nutrition and body weight guidelines for patients with HF who are overweight and obese.