Muscle Mass Found To Be More Important Than BMI

In previous studies examining the relationship between body composition and mortality, it was found that muscle mass had shown to have a protective effect on a healthy person's metabolism and mortality. This study was done using the bio electrical impedance scale, but data from a new study was used which incorporated a more rigorous method to measure body composition called dual X-ray absorptiometry. 

The study

Researchers from the University of Los Angeles, California have analyzed data which has shown that patients with known cardiovascular disease, and who have a low fat mass together with a high muscle mass, have a lower mortality risk than those patients with cardiovascular disease and other body compositions. The research findings also suggested that a higher muscle mass, regardless of the patient's fat mass, aids in reducing the patient's mortality risk. 

The researchers analyzed data, from the National Health and Nutrition Examination Survey of 1999-2004, of nearly 6,500 participants who were diagnosed with cardiovascular disease. The participants were then divided into 4 groups, namely:

• Low fat/low muscle mass.
• Low fat/high muscle mass.
• High fat/low muscle mass.
• High fat/high muscle mass.

The findings

Clinical significance of the study

These findings have shown the importance of trying to maintain muscle mass instead of just focusing on weight loss in order to improve and prolong one's quality of life, especially in patients with known cardiovascular disease.

Health care professionals should then encourage their patients that any weight loss attempt should be coupled together with resistance and strength training exercises. Combining strength training and aerobic exercises would then offer the best benefit by increasing muscle mass and reducing fat mass, respectively. 

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Complications of cardiovascular disease

If muscle mass isn't improved then the following are possible complications which can affect a patient.

• Myocardial infarction - more commonly known as a heart-attack, the coronary arteries of the heart narrow or become obstructed thereby reducing blood flow to the heart. This results in decreased oxygen to the heart muscle and this causes damage to the tissue.
• Cardiac failure - the heart doesn't pump properly anymore and blood flow to the rest of the body is compromised.
• Cerebrovascular incident - better known as a stroke, narrowing or obstruction to arteries supplying the brain causes decreased blood flow to this organ. The result is that the brain tissue gets damaged which can be irreversible.
• Peripheral artery disease - hardening of the arteries (atherosclerosis) can lead to peripheral artery disease. Here the peripheral areas of the body, most commonly the legs, don't receive enough blood flow. The result is that symptoms such as claudication (pain when walking) can occur. The obstruction can be severe enough to cause total blood flow blockage which ultimately results in amputation of the limb.

Cardiac Failure: Signs, Types, Risk Factors & Complications

Unfortunately, not all conditions which lead to cardiac failure can be reversed, but there are treatments available to help control these conditions as well as manage the signs and symptoms of cardiac failure and therefore improve a patient's quality of life.

Signs and symptoms

A patient may have an acute onset of cardiac failure of the condition may be a chronic one. There can also be acute-on-chronic scenarios where the patient's signs and symptoms are exacerbated. The following are issue which these patients could be dealing with:

• Weakness and fatigue.
• Decreased ability to concentrate.
• Shortness of breath when exerting oneself, when standing, sitting or even when lying down.
• Rapid and/or irregular heartbeat.
• Fluid retention (oedema) around the feet, ankles and lower legs. This can cause pitting oedema where finger depressions are left in the skin when pressing on the fluid filled areas.
• Swelling of the abdomen (ascites).
• Increased urinary urgency and/or frequency.
• Persistent coughing or wheezing.
• Coughing up pink, frothy sputum (due to fluid buildup in the lungs).
• Reduced ability to exercise.
• Weight gain due to fluid retention.
• Chest pain.

Types of heart failure

The type of heart failure a patient has will depend on which side of the heart is damaged due to certain conditions. The different types of heart failure are as follows:

• Right-sided heart failure  - the right ventricle doesn't work properly which leads to fluid building up in the lungs resulting in the respiratory symptoms mentioned.
• Left-sided heart failure - the left ventricle is ineffective which results in fluid building up in the extremities and the abdomen leading to swelling of these areas.
• Diastolic heart failure - the left ventricle can't relax properly and therefore doesn't fill up properly. This indicates a filling problem.
• Systolic heart failure - the left ventricle doesn't contract properly. This indicates a pumping problem.
• Congestive cardiac failure - combined left and right heart failure.

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Risk factors 

Certain risk factors are associated with developing cardiac failure and they are:

• As mentioned; heart attacks, coronary artery disease and hypertension.
• Diabetes - this increases the risk of developing the already mentioned risk factors.
• Congenital heart defects.
• Valvular heart disease.
• Viruses which can damage heart muscle.
• Tobacco use.
• Alcohol use.
• Sleep apnoea can increase the risk of arrythmias.
• Diabetic medications such as the thiazolidinediones/glitazones.
• Decreased muscle mass.

Complications 

Cardiac failure can result in many complications. Since fluid builds up in the body, many other organs can be negatively affected and then the following issues can occur:

• Heart valve problems - when the heart muscle enlarges, the valves then can't close and function properly. 
• Kidney damage or failure - the kidneys receive less blood due to cardiac failure and this can cause damage to these organs. Patients may need dialysis or kidney transplants.
• Liver damage - cardiac failure can lead to pressure being built up in the liver. This then causes scarring and damage to the liver which may result in dysfunction of this organ.
• Arrythmias.