{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T19:13:01Z","timestamp":1793041981507,"version":"4.5.0"},"reference-count":46,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T00:00:00Z","timestamp":1773792000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"ABBOTT LABORATORIES S.A","award":["C22293"],"award-info":[{"award-number":["C22293"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Malnutrition and altered body composition are frequent in chronic heart failure (HF) and are associated with worse functional status and prognosis. Bioelectrical impedance analysis (BIA) is increasingly used in nutritional assessment, although its interpretation may be confounded by fluid overload. This study aimed to evaluate the association between BIA-derived parameters and clinical and biochemical markers of disease severity in ambulatory patients with chronic heart failure. Methods: This cross-sectional study included adult outpatients with chronic HF consecutively assessed in a specialised HF unit. Nutritional evaluation comprised anthropometry, handgrip strength, rectus femoris muscle ultrasound and BIA. Phase angle (PA) and hydration-related parameters were analysed in relation to New York Heart Association (NYHA) functional class and N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels. Multivariable regression models adjusted for relevant clinical and BIA variables were applied. Results: A total of 115 patients were included (mean age 68.2 \u00b1 12.6 years; 71.3% men). Mean PA was 4.6 \u00b1 1.1\u00b0. Lower PA was independently associated with greater dyspnoea severity (p = 0.026) and higher NT-proBNP concentrations (p = 0.014). Higher total body water was positively associated with symptom burden (p = 0.013) and NT-proBNP levels (p &lt; 0.001) and showed good discriminatory performance for identifying patients in the highest NT-proBNP quartile. Conclusions: In ambulatory patients with chronic HF, BIA-derived parameters reflecting cellular integrity and hydration status are independently associated with clinical and biochemical markers of disease severity. BIA may provide complementary information in nutritional assessment, although hydration-related confounding should be carefully considered. Future longitudinal studies should determine whether these bioimpedance-derived parameters can improve risk stratification and nutritional assessment in chronic heart failure.<\/jats:p>","DOI":"10.3390\/jcm15062315","type":"journal-article","created":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T10:11:12Z","timestamp":1773828672000},"page":"2315","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Associations of Bioelectrical Impedance-Derived Phase Angle and Hydration Parameters with Clinical Severity in Ambulatory Chronic Heart Failure"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-2768-8151","authenticated-orcid":false,"given":"Carolina","family":"Moreno-Torres-Taboada","sequence":"first","affiliation":[{"name":"Endocrinology and Nutrition Department, Hospital Regional Universitario de M\u00e1laga, 29010 M\u00e1laga, Spain"},{"name":"Department of Medicine and Dermatology, Faculty of Medicine, University of Malaga, 29016 M\u00e1laga, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0739-2567","authenticated-orcid":false,"given":"Francisco Jos\u00e9","family":"S\u00e1nchez-Torralvo","sequence":"additional","affiliation":[{"name":"Endocrinology and Nutrition Department, Hospital Regional Universitario de M\u00e1laga, 29010 M\u00e1laga, Spain"},{"name":"Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga (IBIMA)\u2014BIONAND Platform, 29590 M\u00e1laga, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda","family":"Garc\u00eda-Olivares","sequence":"additional","affiliation":[{"name":"Endocrinology and Nutrition Department, Hospital Regional Universitario de M\u00e1laga, 29010 M\u00e1laga, Spain"},{"name":"Department of Medicine and Dermatology, Faculty of Medicine, University of Malaga, 29016 M\u00e1laga, Spain"},{"name":"Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga (IBIMA)\u2014BIONAND Platform, 29590 M\u00e1laga, Spain"},{"name":"Endocrinology and Nutrition Department, Hospital Quir\u00f3nSalud, 29004 M\u00e1laga, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonia","family":"Castillo-L\u00f3pez","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital Regional Universitario de M\u00e1laga, 29010 M\u00e1laga, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandro","family":"P\u00e9rez-Espejo","sequence":"additional","affiliation":[{"name":"Department of Medicine and Dermatology, Faculty of Medicine, University of Malaga, 29016 M\u00e1laga, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Mar\u00eda","family":"P\u00e9rez-Ruiz","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital Regional Universitario de M\u00e1laga, 29010 M\u00e1laga, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7646-2899","authenticated-orcid":false,"given":"Gabriel","family":"Olveira","sequence":"additional","affiliation":[{"name":"Endocrinology and Nutrition Department, Hospital Regional Universitario de M\u00e1laga, 29010 M\u00e1laga, Spain"},{"name":"Department of Medicine and Dermatology, Faculty of Medicine, University of Malaga, 29016 M\u00e1laga, Spain"},{"name":"Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga (IBIMA)\u2014BIONAND Platform, 29590 M\u00e1laga, Spain"},{"name":"Biomedical Research Networking Center in Diabetes and Associated Metabolic Disorders (CIBERDEM), Instituto de Salud Carlos III, 29010 M\u00e1laga, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1045","DOI":"10.1016\/S0140-6736(18)32216-5","article-title":"Beyond pharmacological treatment: An insight into therapies that target specific aspects of heart failure pathophysiology","volume":"393","author":"Normand","year":"2019","journal-title":"Lancet"},{"key":"ref_2","first-page":"221","article-title":"Implicaciones m\u00e9dicas y nutricionales en insuficiencia cardiaca cr\u00f3nica: Fortalezas y limitaciones","volume":"91","year":"2021","journal-title":"Arch. 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