Abstract 4145354: Sex Differences in Body Composition of Heart Failure Patients and its Relationship with Exercise Performance

Introduction: Bioelectrical impedance analysis (BIA) is a non-invasive method to assess body composition and fluid status. The aim of this study was to investigate the differences in body composition and exercise performance by HF type and sex. Methods: This study is a retrospective analysis of patients with HF who had left ventricular ejection fraction (LVEF) <50% in a single tertiary center from August 2020 to December 2022. A total of 302 patients underwent body composition assessment using BIA, and exercise capacity was measured with a 6-minute walk test (6MWT). The type of HF was divided into ischemic and non-ischemic HF (NIC-HF). Ischemic heart failure (IC-HF) was defined as the presence of a history of percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) surgery. Results: The median age of the study participants was 64 [IQR: 54.3 - 72] years old, and 209 individuals (69%) were men. Among male patients, 78 (37%) had IC-HF and 131 (63%) had NIC-HF. Among female patients, 17 (18%) had IC-HF and 75 (82%) had NIC-HF. There was no statistical difference in skeletal muscle mass, total muscle mass, body fat mass, and visceral fat area between the NIC-HF and the IC-HF groups in men. However, the IC-HF group had higher body mass index (27.5kg/m 2 vs 24.2kg/m 2 , p=0.009), body fat mass (p=0.002), and visceral fat area (p=0.002) than the NIC-HF group regardless of age, although there was no difference in total muscle mass (p=0.129) and body weight (64.3kg vs 58.4kg, p=0.07) in women. The 6MWT did not show any differences by HF type in men. However, in women, the IC-HF group had a shorter 6MWT distance than the NIC-HF group (p=0.02). The increased visceral fat area showed an association with a shorter 6MWT distance in both women (p=0.004), regardless of age and type of HF. Conclusion: After adjustment for age, there were no statistical differences in body composition between the two HF groups in the males. Unlike men, women had lower exercise capacity in the IC-HF group than in the NIC-HF group, which may be partly explained by the relationship between the difference in visceral fat area and exercise capacity according to heart failure type in women.