IJCS | Volume 32, Nº2, March/April 2019

148 Table 3 - Accuracy and concordance between anthropometric methods and fat free mass index in the evaluation of protein malnutrition in patients with HF Variables/categories Protein malnutrition (FFMI kg/m 2 ) S E PPV NPV Accuracy Kappa Yes No Low weight (BMI) Yes 3 1 43% 98% 75% 92% 38.5% 0.50 No 4 45 Mass deficit lean (AMC) Yes 6 12 86% 74% 33% 97% 66.4% 0.36 No 1 34 Low musculature (cAMA) Yes 5 15 0% - - - - - No 0 31 Musculature reduced (APMT) Yes 0 1 0% - - - - - No 6 45 S: sensitivity; Sp: specificity; PPV: positive predictive value; NPV: negative predictive value; BMI: body mass index; AMC: arm muscle circumference; cAMA: corrected arm muscle circumference; AMPT: adductor pollicis muscle thickness. Table 4 - Accuracy and concordance between anthropometric methods and BF% indicator in the evaluation of excess fat and adiposity in patients with HF Variables/categories Excess fat (BF%) Sp E PPV NPV Accuracy Kappa Yes No Excess adiposity (TST) Yes 20 6 60% 68% 77% 50% 20.3% 0.27 No 13 13 Overweight (BMI) Yes 22 8 67% 58% 73% 50% 22.2% 0.24 No 11 11 S: sensitivity; Sp: specificity; PPV: positive predictive value; NPV: negative predictive value; BF%: body fat percentage; TST: triceps skinfold thickness; BMI: body mass index. Rocha et al. Nutritional assessment in heart failure Int J Cardiovasc Sci. 2019;32(2)143-151 Original Article On the other hand, for the evaluation of muscle depletion, AMC and cAMA identified higher percentages of individualswithmuscle depletion, withAMCbeing the most sensitive one, with acceptable concordance with the FFMI parameter. In view of these findings, it is assumed that the AMC and cAMA anthropometric indicators may overestimate the cases of muscle depletion, whichmay be associated to the evaluationmethod, which presupposes equations that require the value of two anthropometric measures, as well as classification in tables of percentiles. However, considering the importance of monitoring the skeletal muscles of individuals with HF, since