Association of altered body composition with cardiac wasting in cancer with and without cardiotoxic therapy

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Abstract
Background and Purpose: In advanced cancer, associations among changes in body composition, cardiac wasting and prior cardiotoxic anticancer therapy have not been investigated. Experimental Approach: Using bioelectrical impedance analysis (BIA), body composition was measured in 206 patients with mostly advanced cancer without known cardiovascular disease or infection (stage III/IV: 84%, prior cardiotoxic anticancer therapy: 55%). Left ventricular (LV) mass was assessed by transthoracic echocardiography and grouped by presence of cardiac wasting according to previously established sex‐specific thresholds for LV mass adjusted for height 2 (2 for women, 2 for men). BIA measurements (indexed to height 2 ) included fat mass index (FMI), fat‐free mass index (FFMI), skeletal muscle mass index (SMMI), visceral fat index (VFI), total body water index (TBWI) and extracellular water index (ECWI). Key Results: Patients with cancer and cardiac wasting ( n = 88) were younger (57±15 vs 62±13 years) and more often women (68% vs 29%) compared to those without cardiac wasting ( n = 118). Patients with cardiac wasting had significantly lower FMI (−12%), FFMI (−14%), SMMI (−16%), VFI (−46%), TBWI (−13%) and ECWI (−14%). For women, FFMI was significantly associated with LV mass/height 2 ( r = 0.41) and VFI for men ( r = 0.40). In the multivariable linear regression analysis, FFMI was the strongest significant predictor of cardiac wasting, with no significant interaction by sex or previous cardiotoxic therapy. Conclusions and Implications: Cardiac wasting in advanced cancer is associated with lower FFMI and VFI independent of prior cardiotoxic therapy.
Funding Information
  • Deutsches Zentrum für Herz-Kreislaufforschung
  • Else Kröner-Fresenius-Stiftung

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