{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T05:04:47Z","timestamp":1790053487993,"version":"4.0.1"},"reference-count":46,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T00:00:00Z","timestamp":1790035200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Right ventricular dysfunction (RVD) is characterized by abnormal RV structure or function and is associated with worse outcomes. In subjects with RVD, cardiac cachexia and sarcopenia were associated with intestinal congestion. However, the prognostic impact and prevalence of body composition phenotypes and phase angle (PhA) in RVD have been insufficiently studied.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess the prognostic impact and prevalence of body composition phenotypes and PhA in RVD,<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A prospective cohort study was conducted. Outpatient subjects over 18\u202fyears old with a confirmed diagnosis of RVD were included. Dynapenia, muscle wasting, and sarcopenia, according to the European Working Group on Sarcopenia in Older People 2 (EWGSOP2), while cachexia was defined according to Evans criteria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 212 subjects with RVD were included. The mean age of the subjects was 64.47\u202f\u00b1\u202f13.99\u202fyears, and 58.96% were men. The prevalence of dynapenia was 28.30%, muscle wasting was 10.38, sarcopenia was 21.70%, and cachexia was 4.25%. The independent risk factors for mortality were PhA\u202f&amp;lt;\u202f5\u00b0 (HR: 2.29, 95% CI: 1.27 to 4.15,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.006), low performance (HR:2.69, 95% CI: 1.25 to 5.81,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.011), sarcopenia (HR: 2.58, 95% CI 1.05 to 6.34;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.038), and cachexia (HR: 4.29, 95% CI 1.29 to 14.24;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.017).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In subjects with RVD, there is a higher prevalence of muscle disorders such as dynapenia, sarcopenia, and cachexia. Besides PhA, sarcopenia and cachexia were associated with a worse prognosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnut.2026.1952746","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T04:22:00Z","timestamp":1790050920000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Body composition phenotypes and phase angle as predictors of mortality in subjects with right ventricular dysfunction: a prospective cohort study"],"prefix":"10.3389","volume":"13","author":[{"given":"Dulce","family":"Gonz\u00e1lez-Islas","sequence":"first","affiliation":[{"name":"Servicio de Cardiolog\u00eda, Instituto Nacional de Enfermedades Respiratorias Ismael Cos\u00edo Villegas","place":["Ciudad de M\u00e9xico, Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arturo","family":"Orea-Tejeda","sequence":"additional","affiliation":[{"name":"Servicio de Cardiolog\u00eda, Instituto Nacional de Enfermedades Respiratorias Ismael Cos\u00edo Villegas","place":["Ciudad de M\u00e9xico, Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Gabriela","family":"Mel\u00e9ndez-Galeana","sequence":"additional","affiliation":[{"name":"Servicio de Cardiolog\u00eda, Instituto Nacional de Enfermedades Respiratorias Ismael Cos\u00edo Villegas","place":["Ciudad de M\u00e9xico, Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"B\u00e1rcenas-Montiel","sequence":"additional","affiliation":[{"name":"Servicio de Cardiolog\u00eda, Instituto Nacional de Enfermedades Respiratorias Ismael Cos\u00edo Villegas","place":["Ciudad de M\u00e9xico, Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danna Paola","family":"Jim\u00e9nez-Cruz","sequence":"additional","affiliation":[{"name":"Servicio de Cardiolog\u00eda, Instituto Nacional de Enfermedades Respiratorias Ismael Cos\u00edo Villegas","place":["Ciudad de M\u00e9xico, Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan David","family":"De la Borda-Paredes","sequence":"additional","affiliation":[{"name":"Servicio de Cardiolog\u00eda, Instituto Nacional de Enfermedades Respiratorias Ismael Cos\u00edo Villegas","place":["Ciudad de M\u00e9xico, Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Estrella","family":"Vargas-Corona","sequence":"additional","affiliation":[{"name":"Servicio de Cardiolog\u00eda, Instituto Nacional de Enfermedades Respiratorias Ismael Cos\u00edo Villegas","place":["Ciudad de M\u00e9xico, Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergio Martin","family":"Alday-Ramirez","sequence":"additional","affiliation":[{"name":"Servicio de Cardiolog\u00eda, Instituto Nacional de Enfermedades Respiratorias Ismael Cos\u00edo Villegas","place":["Ciudad de M\u00e9xico, Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Carlos","family":"Ruan-D\u00edaz","sequence":"additional","affiliation":[{"name":"Servicio de Cardiolog\u00eda, Instituto Nacional de Enfermedades Respiratorias Ismael Cos\u00edo Villegas","place":["Ciudad de M\u00e9xico, Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benigno","family":"Valderr\u00e1bano-Salas","sequence":"additional","affiliation":[{"name":"Servicio de Cardiolog\u00eda, Instituto Nacional de Enfermedades Respiratorias Ismael Cos\u00edo Villegas","place":["Ciudad de M\u00e9xico, Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Flores-Cisneros","sequence":"additional","affiliation":[{"name":"Direcci\u00f3n General de Epidemiolog\u00eda, Secretar\u00eda de Salud","place":["Ciudad de M\u00e9xico, Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,22]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"e578","DOI":"10.1161\/cir.0000000000000560","article-title":"Evaluation and management of right-sided heart failure: a scientific statement from the American Heart Association","volume":"137","author":"Konstam","year":"2018","journal-title":"Circulation"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"893","DOI":"10.1007\/s41999-024-00950-x","article-title":"Sarcopenia is linked to higher levels of B-type natriuretic peptide and its N-terminal fragment in heart failure: a systematic review and Meta-analysis","volume":"15","author":"Prokopidis","year":"2024","journal-title":"Eur Geriatr Med"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"282","DOI":"10.3390\/nu17020282","article-title":"Sarcopenia and cardiogeriatrics: the links between skeletal muscle decline and cardiovascular aging","volume":"17","author":"Anagnostou","year":"2025","journal-title":"Nutrients"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1016\/j.ijcard.2013.08.134","article-title":"Cardiac Cachexia is associated with right ventricular failure and liver dysfunction","volume":"169","author":"Valentova","year":"2013","journal-title":"Int J Cardiol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1684","DOI":"10.1093\/eurheartj\/ehw008","article-title":"Intestinal congestion and right ventricular dysfunction: a link with appetite loss, inflammation, and Cachexia in chronic heart failure","volume":"37","author":"Valentova","year":"2016","journal-title":"Eur Heart J"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"886","DOI":"10.1016\/j.nut.2011.11.024","article-title":"Cachexia assessed by bioimpedance vector analysis as a prognostic Indicator in chronic stable heart failure patients","volume":"28","author":"Castillo-Mart\u00ednez","year":"2012","journal-title":"Nutrition"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"260","DOI":"10.1002\/clc.23970","article-title":"Prevalence of sarcopenia and its association with clinical outcomes in heart failure: an updated Meta-analysis and systematic review","volume":"46","author":"Chen","year":"2023","journal-title":"Clin Cardiol"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"2536","DOI":"10.1002\/jcsm.13596","article-title":"Prognostic impact and prevalence of Cachexia in patients with heart failure: a systematic review and meta-analysis","volume":"15","author":"Prokopidis","year":"2024","journal-title":"J Cachexia Sarcopenia Muscle"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1093\/ageing\/afy169","article-title":"Sarcopenia: revised European consensus on definition and diagnosis","volume":"48","author":"Cruz-Jentoft","year":"2019","journal-title":"Age Ageing"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"4288","DOI":"10.3390\/jcm14124288","article-title":"Muscle or heart? Functional impact of sarcopenia and heart failure in geriatric inpatients","volume":"14","author":"Donca","year":"2025","journal-title":"J Clin Med"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"793","DOI":"10.1016\/j.clnu.2008.06.013","article-title":"Cachexia: a new definition","volume":"27","author":"Evans","year":"2008","journal-title":"Clin Nutr"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"226","DOI":"10.1002\/ejhf.478","article-title":"Contemporary management of acute right ventricular failure: a statement from the heart failure association and the working group on pulmonary circulation and right ventricular function of the European Society of Cardiology","volume":"18","author":"Harjola","year":"2016","journal-title":"Eur J Heart Fail"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"387","DOI":"10.1016\/j.cardfail.2021.01.022","article-title":"Universal definition and classification of heart failure: a report of the Heart Failure Society of America, heart failure Association of the European Society of cardiology, Japanese heart failure society and writing Committee of the Universal Definition of heart failure","volume":"27","author":"Bozkurt","year":"2021","journal-title":"J Card Fail"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"424","DOI":"10.1111\/resp.14892","article-title":"Dynapenia and sarcopenia as risk factors for mortality in interstitial lung disease","volume":"30","author":"Ibarra-Fern\u00e1ndez","year":"2025","journal-title":"Respirology"},{"key":"ref15","volume-title":"Anthropometric Standardization Reference Manual","author":"Lohman","year":"1988"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1016\/j.clnesp.2017.01.010","article-title":"Handgrip strength: reference values and its relationship with bioimpedance and anthropometric variables","volume":"19","author":"Rodr\u00edguez-Garc\u00eda","year":"2017","journal-title":"Clin Nutr ESPEN"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"810","DOI":"10.1093\/ajcn\/41.4.810","article-title":"Assessment of fat-free mass using bioelectrical impedance measurements of the human body","volume":"41","author":"Lukaski","year":"1985","journal-title":"Am J Clin Nutr"},{"key":"ref18","first-page":"228","article-title":"An\u00e1lisis convencional y vectorial de bioimpedancia en la pr\u00e1ctica cl\u00ednica","volume":"22","author":"Piccoli","year":"2002","journal-title":"Nefrologia"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.rmed.2017.11.006","article-title":"Malnutrition and sarcopenia assessment in patients with chronic obstructive pulmonary disease according to international diagnostic criteria, and evaluation of raw BIA variables","volume":"134","author":"de Blasio","year":"2018","journal-title":"Respir Med"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"667","DOI":"10.1016\/j.clnu.2014.07.010","article-title":"Assessing appendicular skeletal muscle mass with bioelectrical impedance analysis in free-living Caucasian older adults","volume":"34","author":"Sergi","year":"2015","journal-title":"Clin Nutr"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"1301","DOI":"10.1038\/s41366-019-0516-8","article-title":"Defining cutoffs to diagnose obesity using the relative fat mass (RFM): association with mortality in NHANES 1999-2014","volume":"44","author":"Woolcott","year":"2005","journal-title":"Int J Obes"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"518","DOI":"10.1164\/rccm.166.4.518","article-title":"ATS\/ERS statement on respiratory muscle testing","volume":"166","year":"2002","journal-title":"Am J Respir Crit Care Med"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"1324","DOI":"10.1093\/gerona\/glaa063","article-title":"Impact of low muscle mass and low muscle strength according to EWGSOP2 and EWGSOP1 in community-dwelling older people","volume":"75","author":"Costanzo","year":"2020","journal-title":"J Gerontol A Biol Sci Med Sci"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"310","DOI":"10.1016\/j.cardfail.2014.02.008","article-title":"Reduced handgrip strength as a marker of frailty predicts clinical outcomes in patients with heart failure undergoing ventricular assist device placement","volume":"20","author":"Chung","year":"2014","journal-title":"J Card Fail"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"2100","DOI":"10.1016\/j.apmr.2018.01.008","article-title":"Muscular strength as a predictor of all-cause mortality in an apparently healthy population: a systematic review and meta-analysis of data from approximately 2 million men and women","volume":"99","author":"Garc\u00eda-Hermoso","year":"2018","journal-title":"Arch Phys Med Rehabil"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1002\/jcsm.12502","article-title":"Muscle mass, strength, and physical performance predicting activities of daily living: a meta-analysis","volume":"11","author":"Wang","year":"2020","journal-title":"J Cachexia Sarcopenia Muscle"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"2113","DOI":"10.1002\/ehf2.15221","article-title":"Prognostic impact of gait speed, muscle strength and muscle mass in chronic heart failure-a prospective cohort study","volume":"12","author":"Cejka","year":"2025","journal-title":"ESC Heart Fail"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"72","DOI":"10.1093\/gerona\/61.1.72","article-title":"Strength, but not muscle mass, is associated with mortality in the health, aging and body composition study cohort","volume":"61","author":"Newman","year":"2006","journal-title":"J Gerontol A Biol Sci Med Sci"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"1579","DOI":"10.3945\/ajcn.2009.28047","article-title":"Longitudinal study of muscle strength, quality, and adipose tissue infiltration","volume":"90","author":"Delmonico","year":"2009","journal-title":"Am J Clin Nutr"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"e16042","DOI":"10.14814\/phy2.16042","article-title":"The effects of Myosteatosis on skeletal muscle function in older adults","volume":"12","author":"Dondero","year":"2024","journal-title":"Physiol Rep"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1093\/postmj\/qgad097","article-title":"Reduced muscle strength is closely linked to computed tomography-defined myosteatosis among inpatients with cirrhosis","volume":"100","author":"Sun","year":"2023","journal-title":"Postgrad Med J"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"1242","DOI":"10.1002\/jcsm.12603","article-title":"Muscle wasting as an independent predictor of survival in patients with chronic heart failure","volume":"11","author":"von Haehling","year":"2020","journal-title":"J Cachexia Sarcopenia Muscle"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"568","DOI":"10.1002\/jcsm.12702","article-title":"Prognostic impact of muscle and fat mass in patients with heart failure","volume":"12","author":"Konishi","year":"2021","journal-title":"J Cachexia Sarcopenia Muscle"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"299","DOI":"10.1007\/s11897-020-00468-w","article-title":"Heart failure-induced skeletal muscle wasting","volume":"17","author":"Philippou","year":"2020","journal-title":"Curr Heart Fail Rep"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"1959","DOI":"10.1002\/jcsm.13306","article-title":"Frailty and heart failure: state-of-the-art review","volume":"14","author":"Talha","year":"2023","journal-title":"J Cachexia Sarcopenia Muscle"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"1183","DOI":"10.1002\/jcsm.13221","article-title":"Sarcopenia and cardiovascular diseases: a systematic review and meta-analysis","volume":"14","author":"Zuo","year":"2023","journal-title":"J Cachexia Sarcopenia Muscle"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"367","DOI":"10.1017\/s0029665115002438","article-title":"The wasting continuum in heart failure: from sarcopenia to cachexia","volume":"74","author":"von Haehling","year":"2015","journal-title":"Proc Nutr Soc"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3390\/nu12010211","article-title":"Sarcopenia and heart failure","volume":"12","author":"Curcio","year":"2020","journal-title":"Nutrients"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"1580","DOI":"10.1002\/ejhf.1304","article-title":"Comparison of sarcopenia and cachexia in men with chronic heart failure: results from the studies investigating co-morbidities aggravating heart failure (SICA-HF)","volume":"20","author":"Emami","year":"2018","journal-title":"Eur J Heart Fail"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"1660","DOI":"10.1016\/j.jacc.2013.06.046","article-title":"Relationships between right ventricular function, body composition, and prognosis in advanced heart failure","volume":"62","author":"Melenovsky","year":"2013","journal-title":"J Am Coll Cardiol"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"1534","DOI":"10.1161\/circulationaha.123.064071","article-title":"Sarcopenia and cardiovascular diseases","volume":"147","author":"Damluji","year":"2023","journal-title":"Circulation"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"oeae082","DOI":"10.1093\/ehjopen\/oeae082","article-title":"Impact of whole-body and skeletal muscle composition on peak oxygen uptake in heart failure: a systematic review and meta-analysis","volume":"4","author":"Schmid","year":"2024","journal-title":"Eur Heart J Open"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"173.e17","DOI":"10.1016\/j.jamda.2014.10.024","article-title":"The bioimpedance phase angle predicts low muscle strength, impaired quality of life, and increased mortality in old patients with cancer","volume":"16","author":"Norman","year":"2015","journal-title":"J Am Med Dir Assoc"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"1148","DOI":"10.1016\/j.chest.2019.01.001","article-title":"Raw bioelectrical impedance analysis variables are independent predictors of early all-cause mortality in patients with COPD","volume":"155","author":"de Blasio","year":"2019","journal-title":"Chest"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"1530","DOI":"10.1016\/j.clnu.2016.04.007","article-title":"Prognostic role of phase angle in hospitalized patients with acute decompensated heart failure","volume":"35","author":"Alves","year":"2016","journal-title":"Clin Nutr"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"104222","DOI":"10.1016\/j.numecd.2025.104222","article-title":"Malnutrition assessed with phase angle and mortality risk in heart failure\u2014a meta-analysis","volume":"35","author":"Popiolek-Kalisz","year":"2025","journal-title":"Nutr Metab Cardiovasc Dis"}],"container-title":["Frontiers in Nutrition"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnut.2026.1952746\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T04:22:01Z","timestamp":1790050921000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnut.2026.1952746\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,22]]},"references-count":46,"alternative-id":["10.3389\/fnut.2026.1952746"],"URL":"https:\/\/doi.org\/10.3389\/fnut.2026.1952746","relation":{},"ISSN":["2296-861X"],"issn-type":[{"value":"2296-861X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,22]]},"article-number":"1952746"}}