<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1405-9940</journal-id>
<journal-title><![CDATA[Archivos de cardiología de México]]></journal-title>
<abbrev-journal-title><![CDATA[Arch. Cardiol. Méx.]]></abbrev-journal-title>
<issn>1405-9940</issn>
<publisher>
<publisher-name><![CDATA[Instituto Nacional de Cardiología Ignacio Chávez]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1405-99402016000400319</article-id>
<article-id pub-id-type="doi">10.1016/j.acmx.2016.06.003</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Valoración de la composición corporal y su influencia pronóstica en insuficiencia cardiaca crónica. Más allá de la «paradoja de la obesidad»]]></article-title>
<article-title xml:lang="en"><![CDATA[Assessment of body composition and prognosis in chronic heart failure. Beyond the &#8220;obesity paradox&#8221;]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gámez-López]]></surname>
<given-names><![CDATA[Antonio Luis]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Bonilla-Palomas]]></surname>
<given-names><![CDATA[Juan Luis]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[López-Ibáñez]]></surname>
<given-names><![CDATA[María Cristina]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Moreno-Conde]]></surname>
<given-names><![CDATA[Mirian]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Anguita-Sánchez]]></surname>
<given-names><![CDATA[Manuel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Villar-Ráez]]></surname>
<given-names><![CDATA[Antonia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="A01">
<institution><![CDATA[,Hospital San Juan de la Cruz  ]]></institution>
<addr-line><![CDATA[Úbeda Jaén]]></addr-line>
<country>España</country>
</aff>
<aff id="A02">
<institution><![CDATA[,Hospital San Juan de la Cruz  ]]></institution>
<addr-line><![CDATA[Úbeda Jaén]]></addr-line>
<country>España</country>
</aff>
<aff id="A03">
<institution><![CDATA[,Hospital Universitario Reina Sofía  ]]></institution>
<addr-line><![CDATA[ Córdoba]]></addr-line>
<country>España</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2016</year>
</pub-date>
<volume>86</volume>
<numero>4</numero>
<fpage>319</fpage>
<lpage>325</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S1405-99402016000400319&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S1405-99402016000400319&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S1405-99402016000400319&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Objetivo Se desconoce la influencia pronóstica que la composición corporal guarda en la relación inversa de la mortalidad con el sobrepeso y la obesidad en pacientes con insuficiencia cardiaca.  Método Se evaluó a 234 pacientes ambulatorios con insuficiencia cardiaca. Se determinaron el índice de masa corporal, el pliegue tricipital, el perímetro muscular braquial y el porcentaje de grasa corporal evaluado mediante impedanciometría bioeléctrica. Se analizó la influencia sobre la mortalidad total de las variables antropométricas citadas.  Resultados El seguimiento medio fue 21 ± 10.7 meses. Se observó una relación inversa de la mortalidad total con el índice de masa corporal (hazard ratio = 0.91; intervalo confianza del 95%, 0.87-0.96; p &lt; 0.001), con la masa grasa estimada por el pliegue tricipital (hazard ratio = 0.95; intervalo confianza del 95%, 0.92-0.99; p = 0.013) y por el porcentaje graso obtenido mediante impedanciometría (hazard ratio = 0.96; intervalo confianza del 95%,0.93-0.99; p = 0.007) y con la masa muscular estimada mediante el perímetro muscular braquial (hazard ratio = 0.87; intervalo confianza del 95%, 0.81-0.94; p = 0.001). Solo el perímetro muscular braquial mantuvo su influencia pronóstica en el análisis multivariante que incluyó a las diferentes medidas antropométricas (hazard ratio = 0.88; intervalo confianza del 95%, 0.77-0.99; p = 0.035). Finalmente, se observó una correlación lineal positiva entre los valores del índice de masa corporal con los del pliegue tricipital, porcentaje graso y perímetro muscular braquial.  Conclusiones La masa muscular del paciente con insuficiencia cardiaca, estimada mediante el perímetro muscular braquial, se asocia de manera inversa con la mortalidad global. La correlación de sus valores con los del índice de masa corporal explicaría la «paradoja de la obesidad» observada.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Objective It is unknown the influence of body composition in the inverse relationship of mortality with overweight and obesity in heart failure patients.  Methods 234 patients with chronic heart failure were evaluated. Body mass index, tricipital skinfold thickness, brachial muscle circumference and body fat percentage determined by bioelectrical impedance analysis were measured. The influence of previous anthropometric variables on total mortality was analyzed.  Results Mean follow-up was 21 ± 10.7 months. We observed an inverse relationship of total mortality with body mass index (hazard ratio = 0.91, 95% confidence interval, 0.87-0.96; P&lt;.001), with body fat estimated by the tricipital skinfold thickness (hazard ratio = 0.95, 95% confidence interval, 0.92-0.99; P=.013) and the fat percentage obtained by bioelectrical impedance analysis (hazard ratio = 0.96; 95% confidence interval, 0.93-0.99; P=.007) and with muscle mass estimated by the brachial muscle circumference (hazard ratio = 0.87; 95% confidence interval,0.81-0.94; P=.001). Only brachial muscle circumference maintained its prognostic significance in multivariate analysis that included different anthropometric measurements (hazard ratio = 0.88, 95% confidence interval 0.77-0.99; P=.035). Finally we found a positive linear correlation between the values of body mass index with tricipital skinfold thickness, fat percentage and brachial muscle circumference.  Conclusions The muscle mass of patients with heart failure, estimated by the brachial muscle circumference, is associated inversely with overall mortality. The correlation between values of brachial muscle circumference with the body mass index would explain the &#8220;obesity paradox&#8221; observed.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Heart failure]]></kwd>
<kwd lng="en"><![CDATA[Body composition]]></kwd>
<kwd lng="en"><![CDATA[Body mass index]]></kwd>
<kwd lng="es"><![CDATA[Insuficiencia cardiaca]]></kwd>
<kwd lng="es"><![CDATA[Composición corporal]]></kwd>
<kwd lng="es"><![CDATA[Índice de masa corporal]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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