Open Access

ARTICLE

Body composition, appetite-related hormones, adipocytokines, and heart failure in adult patients with congenital heart disease: A preliminary study

Yumi Shiina¹, Tomoaki Murakami², Noriko Matsumoto³, Daisuke Okamura⁴, Yuta Takahashi⁴, Yosuke Nishihata¹, Nobuyuki Komiyama¹, Koichiro Niwa¹

1 Department of Cardiology, Cardiovascular Center, St. Luke’s International Hospital, Tokyo, Japan
2 Department of Cardiology, Chiba Children’s Hospital, Chiba, Japan
3 Department of Nutrition, St. Luke’s International Hospital, Tokyo, Japan
4 Department of rehabilitation, St. Luke’s International Hospital, Tokyo, Japan

* Corresponding Author: Tomoaki Murakami, MD, PhD, Department of Cardiology, Chiba Children’s Hospital, 579-1 Heta-cho, Midori-ku, Chiba 266- 0007 Japan. Email:

Congenital Heart Disease 2018, 13(1), 79-84. https://doi.org/10.1111/chd.12555

Abstract

Objectives: To assess body composition and relationships among body composition, appetiterelated hormones, adipocytokines, and heart failure (HF) in adult patients with congenital heart disease (CHD).
Patients: This prospective study enrolled 46 consecutive adult patients with CHD and 12 agematched healthy controls. The patients and control subjects were divided into four groups: 13 patients with Fontan circulation (group A), 16 patients with cyanosis (group B), 17 patients who previously underwent biventricular repair (group C), and 12 age-matched healthy controls.
Design: Body composition was measured using InBody730, and levels of appetite-related hormones (ghrelin and leptin) and adipocytokines (leptin, interleukin-6, and tumor necrosis factor-a) were determined. Relationships of these measurements between severe HF, defined as New York Heart Association functional class III–IV and/or recent repeated unscheduled hospitalizations due to HF, were examined using univariate logistic analysis.
Results: Mean patient age was 32.1 ± 7.4 years. The skeletal muscle mass was significantly decreased in groups A and B compared with that in controls. Interestingly, ghrelin levels in groups A and B were also significantly lower than those in controls. Univariate logistic analysis revealed that ghrelin level, percent body fat, and pulse oximetric oxygen saturation were significantly associated with severe HF.
Conclusions: Patients with Fontan circulation and those with cyanosis might be at a risk of sarcopenia. Despite the decreased skeletal muscle mass and increased body fat, ghrelin levels in these patients were decreased. These changes might have a negative impact on HF in these patients.

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