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

Authors

Sara Hadzibegovic, Jonathan L Hella, Jan Porthun, Alessia Lena, Danara Krug, Iulia Baluta, Ursula Wilkenshoff, Amir A Mahabadi, Matthias Totzeck, Tienush Rassaf, Stefan D Anker, Wolfram Doehner, Ulrich Keller, Lars Bullinger, Dominik P Modest, Barry J A Laird, Richard J E Skipworth, John G F Cleland, Christian Oeing, Stephan von Haehling, Ulf Landmesser, Markus S Anker

Published in

British journal of pharmacology. Oct 07, 2026. Epub Oct 07, 2026.

Abstract

In advanced cancer, associations among changes in body composition, cardiac wasting and prior cardiotoxic anticancer therapy have not been investigated.
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 height² (<61 g/m² for women, <57 g/m² for men). BIA measurements (indexed to height²) 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).
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/height² (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.
Cardiac wasting in advanced cancer is associated with lower FFMI and VFI independent of prior cardiotoxic therapy.

PMID:
42843837
Bibliographic data and abstract were imported from PubMed on 08 Oct 2026.

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