Association of sarcopenia defined by different skeletal muscle mass measurements with prognosis and quality of life in older patients with heart failure

IF 2.5 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Journal of cardiology Pub Date : 2023-12-21 DOI:10.1016/j.jjcc.2023.12.003

Kaoru Sato PT , Kentaro Kamiya PT, PhD, FJCC , Nobuaki Hamazaki PT, PhD , Kohei Nozaki PT, PhD , Takafumi Ichikawa PT , Shota Uchida PT, PhD , Kensuke Ueno PT, MSc , Masashi Yamashita PT, PhD , Takumi Noda PT, MSc , Ken Ogura PT, MSc , Takashi Miki PT, MSc , Kazuki Hotta PT, PhD , Emi Maekawa MD, PhD , Minako Yamaoka-Tojo MD, PhD, FJCC , Atsuhiko Matsunaga PT, PhD , Junya Ako MD, PhD, FJCC

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Abstract

Background

Diagnosing sarcopenia in heart failure (HF) patients is important, but how to assess skeletal muscle mass in HF patients with fluid retention is controversial. We aimed to examine the association between sarcopenia, defined by different skeletal muscle mass measurements, and clinical outcomes in older HF patients.

Methods

We included 546 older HF patients (≥ 65 years) who were assessed for sarcopenia at discharge (median age 77 years, 309 males). Sarcopenia was diagnosed using grip strength, usual gait speed, and skeletal muscle mass according to international criteria. We used mid-upper arm circumference (MUAC), mid-upper arm muscle circumference (MAMC), calf circumference (CC), and skeletal muscle mass index (SMI) assessed by bioelectrical impedance analysis to assess skeletal muscle mass and defined sarcopenia in each of these measurements. Prognostic outcomes were composite events (all-cause death and HF rehospitalization) and cardiovascular disease (CVD) events (CVD death and CVD rehospitalization). Quality of life (QOL) was assessed using the 36-item Short-Form Health Survey physical functioning (SF-36PF) score.

Results

The sarcopenia defined by MUAC [hazard ratio (HR): 2.50; 95 % confidence interval (95 % CI): 1.64–3.81; p < 0.001] or MAMC (HR: 1.98; 95 % CI: 1.35–2.92; p = 0.001) were associated with higher composite event rates than the non-sarcopenia. The sarcopenia defined by MUAC (HR: 1.88; 95 % CI: 1.25–2.83; p = 0.002) or MAMC (HR: 1.70; 95 % CI: 1.16–2.49; p = 0.007) were associated with higher CVD event rates than the non-sarcopenia. The sarcopenia defined by CC or SMI were not associated with prognoses. The sarcopenia defined by MUAC, MAMC, or CC were associated with low SF-36PF scores (all p < 0.05).

Conclusions

These results suggest that a diagnosis of sarcopenia based on MUAC or MAMC rather than CC or SMI reflects prognosis and QOL in older HF patients.

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以不同骨骼肌质量测量方法定义的肌肉疏松症与老年心力衰竭患者预后和生活质量的关系

背景诊断心力衰竭（HF）患者的 "肌肉疏松症 "非常重要，但如何评估有体液潴留的 HF 患者的骨骼肌质量却存在争议。我们旨在研究通过不同骨骼肌质量测量方法定义的肌肉疏松症与老年心力衰竭患者临床预后之间的关联。方法根据国际标准，使用肌力（握力）、体能（通常步速）和骨骼肌质量诊断肌肉疏松症。我们使用中上臂围（MUAC）、中上臂肌围（MAMC）、小腿围（CC）和生物电阻抗分析评估的骨骼肌质量指数（SMI）来评估骨骼肌质量，并根据这些测量值来定义肌肉疏松症。预后结果为综合事件（全因死亡和高血压再住院）和心血管疾病（心血管疾病）事件（心血管疾病死亡和心血管疾病再住院），并使用36项短式健康调查身体功能（SF-36PF）评分来衡量生活质量（QOL）。结果以 MUAC [危险比 (HR): 2.50; 95 % 置信区间 (95 % CI): 1.64-3.81; p < 0.001]或 MAMC (HR: 1.98; 95 % CI: 1.35-2.92; p = 0.001)定义的肌肉疏松症组的综合事件发生率高于非肌肉疏松症组。以 MUAC（HR：1.88；95 % CI：1.25-2.83；p = 0.002）或 MAMC（HR：1.70；95 % CI：1.16-2.49；p = 0.007）定义的肌肉疏松症组的心血管疾病事件发生率高于非肌肉疏松症组。以 CC 或 SMI 定义的肌肉疏松症组与预后结果无关。结论本研究结果表明，基于 MUAC 或 MAMC 而非 CC 或 SMI 的肌肉疏松症诊断可反映老年心房颤动患者的预后和 QOL。

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来源期刊

Journal of cardiology CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

4.90

自引率

8.00%

发文量

202

审稿时长

29 days

期刊介绍： The official journal of the Japanese College of Cardiology is an international, English language, peer-reviewed journal publishing the latest findings in cardiovascular medicine. Journal of Cardiology (JC) aims to publish the highest-quality material covering original basic and clinical research on all aspects of cardiovascular disease. Topics covered include ischemic heart disease, cardiomyopathy, valvular heart disease, vascular disease, hypertension, arrhythmia, congenital heart disease, pharmacological and non-pharmacological treatment, new diagnostic techniques, and cardiovascular imaging. JC also publishes a selection of review articles, clinical trials, short communications, and important messages and letters to the editor.