Total body water to lean body mass ratio predicts mortality in patients with chronic heart failure: a prospective, observational study.

Background: Malnutrition and sodium water retention are some of the most common complications of chronic heart failure (CHF). To date, several parameters or risk stratification tools have been established to predict one's volume or nutritional status. Unfortunately, there is no biomarker that may reflect both conditions, thus, in this study, we established a novel biomarker known as total body water (TBW) to lean body mass ratio (LBM) ratio (TLR). Accordingly, we also assessed the prognostic value of TLR in CHF patients. Methods: A total of 401 consecutive patients with CHF from August 2019 to October 2021 were prospectively enrolled. TBW and LBM were obtained by InBody S10. The primary endpoint was long-term all-cause and cardiovascular mortality. The cut-off and prognostic value of TLR was determined by receiver operating characteristic curves and Cox regression analysis. Patients were then divided into two groups according to the cut-off value of TLR. Results: During a median follow-up of 1,200 days, the high-TLR group (TLR ≥ 0.783) was presented with a higher all-cause mortality (41.27% vs. 18.40%, Conclusion: The TLR may serve as a novel composite biomarker that reflects both volume and nutritional status in CHF patients and is associated with long-term prognosis. Its prognostic performance appears comparable to several established biomarkers, though further validation is warranted.