BIOELECTRICAL IMPENDANCE ANALYSIS OF BODY COMPOSITION IN PATIENTS WITH CHRONIC HEART FAILURE.

Evaluation of body composition is important in countries of different populations and morbidities. One of the groups of morbidity consists of patients with chronic heart failure, where the body fat mass as well as fat-free mass and several other parameters are likely to have an impact on severity and/or outcome of the disease and patient's quality of life. The purpose of the study was to analyze the parameters of body composition in patients with chronic heart failure. Study included 86 patients, fit for the purpose of the study, and 30 practically healthy individuals. Body mass and other measurement data (height, waist circumference, hip circumference and waist-to-hip ratio, anthropometric measurements) were evaluated. Bioelectrical impedance (BIA) was analyzed by BIA 450, BIODYNAMICS (USA) in accordance with standard procedures that are widely accepted. Fat free mass (FFM) was determined by the BIA method. This index was also calculated by prediction equation based on BIA and anthropometric parameters: FFM (kg) = 11.78 + (0.499 x H2/R) + (0.134 x Weight) + (3.449 x gender), where H stands for height in cm, R represents resistance in Ω, Weight is measured in kg and "gender" equals to 0 for females and 1 - for males (3). FFMI equals to the ratio of FFM (kg) to the square of the height; Ratio of FMI - FM (kg) to the square of the height. Study showed that in both patients' and control groups, underweight, as well as overweight individuals are present; also, in both groups, obesity, as BMI category, is most common. Groups (patients vs control) differed in Reactance and FFM (kg) (P<0.009). There was no statistically significant difference between male subgroups of patient and control groups; Valid differences in resistance, lean body mass and fat free mass (kg) were observed between female subgroups. Analysis of body composition characteristics in patients with chronic heart failure revealed that functional classes of heart failure differ in several BIA data, including resistance, Lean body mass (kg) and Fat Free Mass (%).

; ASPECTS OF NUTRITION IN PATIENTS WITH CONGESTIVE HEART FAILURE.

Congestive heart failure (CHF) is a significant healthcare problem, and is associated with high levels of morbidity and mortality. The majority of patients have poor quality of life in spite of the modern evidence-based treatment. Malnutrition is more common in patients with HF, especially at the severe stage of HF, and is associated with the risk of complications and mortality. Consequently, evaluation of malnutrition in patients with HF, monitoring of patients in this regard, and identifying the right assessment tools are the basis for developing of an effective nutritional strategy that can have a significant impact on the treatment and management of such patients.; Our aim was to study the prevalence of different markers of malnutrition, their association with nutrient indices, and their correlation with CHF in Georgian population.; The total of 96 patients relevant to the research objective (43 female and 53 male with average age 69.85) were enrolled in the study. Nutritional screening was performed using the GNRI, which was calculated as follows: GNRI=14.89× serum albumin (g/dL) +41.7*body weight÷ideal body weight. Ideal body weight=22* square of height in meters and PNI was calculated as follows: PNI=10* serum albumin (g/dL) +0.005*total lymphocyte (count per mm3) and The Controlling Nutritional Status (CONUT) score was calculated by serum albumin score plus total cholesterol score and total lymphocyte score. Peripheral venous blood was tested for acute phase reactant (hsCRP, Interleukin-6, fibrinogen, acid glycoprotein) and for protein-energy malnutrition (prealbumin, albumin, lymphocytes, lipid profile and transferrin).; By examining the correlation between the CONUT, GNRI and PNI indices, a significant negative correlation was found between CONUT and PNI. We quantitatively compared results obtained using CONUT, GNRI and PNI scale risk groups, as the primary picture suggested it in our study group (ambulatory, quite compensated CHF). CONUT and PNI represent best option.; Prealbumin, lipid profile data, transferrin decreases with increasing risk for CONUT and PNI, with Interleukin-6 increasing on both calculators. Changes in other data are not correlated.

DEMOGRAPHIC AND CLINICAL FACTORS ASSOCIATED WITH INCREASED IL-6 LEVELS IN AMBULATORY PATIENTS WITH CHRONIC HEART FAILURE.

IL-6 promotes T cell activation and production in acute inflammatory conditions, initiates B cell differentiation, regulates liver production of acute phase reactants, and stimulates hypothalamus-pituitary-adrenal system, which is important in acute inflammation. Nevertheless prolonged IL-6 exposition activates apoptosis. According to recent studies increased levels of IL-6 increase cardiovascular disease risks. The aim of the study was to explore IL-6 basic levels in chronic congestive heart failure patients, as in risk group in COVID-19, and various factors (demographic or clinical) in various groups of IL-6 basic levels. We used consecutive sampling approach to recruit 96 congestive heart failure patients and 34 persons without the condition as controls. Hematologic, biochemical and immunologic parameters were measured using conventional methods. We used descriptive statistics for demographic parameters. We compared mean values of hematologic and biochemical parameters in cases and controls using independent sample t test and explored differences within the congestive heart failure group (further separated in 3 groups according to IL-6 levels) using one way ANOVA test, with further post-hoc analysis. Levels of IL-6 are statistically significantly higher in CHF patients; groups differ in co-morbidity, also abdominal obesity is more prevalent in diseased group. Difference between groups is significant in a number of pro-inflammation, coagulation, hematology parameters. It is also important to note that the CHF group showed a number of differences in sub-groups according to IL-6 levels, risks of CHF and comorbidity deterioration risks therefore are suggested to be different.