Features basal metabolism and body composition in obese patients,and diastolic heart failure

Authors: Bogdanov A.R., Derbeneva S.A., Bogdanova A.A.

Company: Institute of Nutrition of Federal Agency for Scientific Organisations; Ust'inskiy proezd, 2/14, Moscow, 109240, Russian Federation


DOI: https://doi.org/10.15275/kreatkard.2015.02.02

For citation: A.R. Bogdanov, S.A. Derbeneva, A.A. BogdanovaFeatures basal metabolism and body composition in obese patients, and diastolic heart failureCreative Cardiology. 2015; 2: 20-29

Received / Accepted:  Received 08.07.2015

Keywords: heart failure obesity basal metabolism energy metabolism body composition diet metabolic status

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Abstract

Objective: to examine the performance of basal metabolism and body composition in obese patients, with diastolic heart failure. Material and methods. We studied the parameters of 222 patients with obesity and diastolic heart failure (DHF) with preserved systolic function of the left ventricle, which were divided into four groups depending on the degree of obesity and the presence or absence of DHF. Patients were evaluated body composition by anthropometry and bioimpedance analysis (BIA), as well as indicators of basal metabolism by indirect calorimetry respiratory.

Results. For patients with obesity and characterized by DHF more pronounced development of skeletal muscle compared with those without it (on average by 8.7%) and the high intensity of the oxidation of proteins (12.3–16.7%, p<0.05). The needs of patients with DHF receipt proteins with higher food and they need to increase the quota of protein in the diet of an average of 8–10%. For the first time it was revealed that, in patients with DHF, the energy characteristics of lean body mass significantly limited, resulting in a reduction of the specific energy expenditure rest (at 13,1%, p<0.001) and the rate of fat oxidation (16%, p<0.01) per unit muscular mass compared to patients without DHF. It was concluded that contributes to the progression of heart failure due to the development of obesity disorders of energy metabolism and fat metabolism.

Conclusion. Patients with morbid obesity is generated “vicious circle”: obesity contributes to a progressive myocardial hypertrophy, cardiac remodeling with the outcome of diastolic heart failure, which in turn leads to gross violations of tissue metabolism (decrease in energy expenditure and basal metabolic efficiency lipid increase protein catabolism), causing further progression of obesity.

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About Authors

  • Bogdanov Al'fred Ravilevich, Chief of Department;
  • Derbeneva Svetlana Anatol'evna, Senior Research Associate;
  • Bogdanova Aleksandra Andreevna, Head of Cabinet of Functional Diagnostics

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery