Low Skeletal Muscle Mass Independently Predicts Mortality in Patients with Chronic Heart Failure after an Acute Hospitalization

Cardiology ◽  
2019 ◽  
Vol 142 (1) ◽  
pp. 28-36 ◽  
Author(s):  
Persio D. Lopez ◽  
Pankaj Nepal ◽  
Adedoyin Akinlonu ◽  
Divya Nekkalapudi ◽  
Kwon Kim ◽  
...  

Background: Heart failure (HF) is a syndrome associated with exercise intolerance, and its symptoms are more common in patients with low skeletal muscle mass (SMM). Estimation of muscle mass can be cumbersome and unreliable, particularly in patients with varying body weight. The psoas muscle area (PMA) can be used as a surrogate of sarcopenia and has been associated with poor outcomes in other populations. Objectives: The aim of this study was to assess if sarcopenia is associated with the survival of patients with HF after an acute hospitalization. Method: We retrospectively studied a cohort of 160 patients with HF who had abdominopelvic computed tomography during an acute hospitalization. We obtained standardized measurements of their PMA and defined sarcopenia as the lowest gender-based tertile of the said area. The patients were followed until death or discontinuation of care. We used Kaplan-Meier estimates and Cox regression analysis to assess the relationship between sarcopenia and all-cause mortality. Results: We found that the 52 patients with sarcopenia had 4.5 times the risk of all-cause mortality at 1 year compared to the rest of the cohort (CI 1.784–11.765; p = 0.0016) after adjusting for significant covariates. Stratification by age and sex revealed that this association could be limited to males and patients < 75 years old. Conclusion: The PMA, used as a surrogate of low SMM, is independently associated with an increased risk of late mortality after an acute hospitalization in patients with HF.

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0247140
Author(s):  
Takehiro Funamizu ◽  
Yuji Nagatomo ◽  
Mike Saji ◽  
Nobuo Iguchi ◽  
Hiroyuki Daida ◽  
...  

Background Acute decompensated heart failure (ADHF) is a growing healthcare burden with increasing prevalence and comorbidities due to progressive aging society. Accumulating evidence suggest that low skeletal muscle mass has a negative impact on clinical outcome in elderly adult population. We sought to determine the significance of psoas muscle area as a novel index of low skeletal muscle mass in elderly patients with ADHF. Methods In this single-center retrospective observational study, we reviewed consecutive 865 elderly participants (65 years or older) who were hospitalized for ADHF and 392 were available for analysis (79 years [74–85], 56% male). Cross-sectional areas of psoas muscle at the level of fourth lumbar vertebra were measured by computed tomography and normalized by the square of height to calculate psoas muscle index (PMI, cm2/m2). Results Dividing the patients by the gender-specific quartile value (2.47 cm2/m2 for male and 1.68 cm2/m2 for female), we defined low PMI as the lowest gender-based quartile of PMI. Multiple linear regression analysis revealed female sex, body mass index (BMI), and E/e’, but not left ventricular ejection fraction, were independently associated with PMI. Kaplan-Meier analysis showed low PMI was associated with higher rate of composite endpoint of all-cause death and ADHF re-hospitalization (P = 0.033). Cox proportional hazard model analysis identified low PMI, but not BMI, was an independent predictor of the composite endpoint (Hazard ratio: 1.52 [1.06–2.16], P = 0.024). Conclusions PMI predicted future clinical adverse events in elderly patients with ADHF. Further studies are needed to assess whether low skeletal muscle mass can be a potential therapeutic target to improve the outcome of ADHF.


2021 ◽  
Vol 11 (7) ◽  
pp. 3146
Author(s):  
Dongmin Lee ◽  
Kyengho Byun ◽  
Moon-Hyon Hwang ◽  
Sewon Lee

Arterial stiffness is associated with an increased risk of cardiovascular disease. Previous studies have shown that there is a negative correlation between arterial stiffness and variables such as skeletal muscle mass, muscular strength, and anaerobic power in older individuals. However, little research has been undertaken on relationships in healthy young adults. This study presents a preliminary research that investigates the association between arterial stiffness and muscular factors in healthy male college students. Twenty-three healthy young males (23.9 ± 0.5 years) participated in the study. The participants visited the laboratory, and variables including body composition, blood pressure, arterial stiffness, blood parameters, grip strength, and anaerobic power were measured. Measurements of augmentation index (AIx) and brachial-ankle pulse wave velocity (baPWV) were performed to determine arterial stiffness. There were significant positive correlations among skeletal muscle mass, muscle strength, and anaerobic power in healthy young adult males. AIx was negatively associated with a skeletal muscle mass (r = −0.785, p < 0.01), muscular strength (r = −0.500, p < 0.05), and anaerobic power (r = −0.469, p < 0.05), respectively. Likewise, AIx@75 corrected with a heart rate of 75 was negatively associated with skeletal muscle mass (r = −0.738, p < 0.01), muscular strength (r = −0.461, p < 0.05), and anaerobic power (r = −0.420, p < 0.05) respectively. However, the baPWV showed no correlation with all muscular factors. Our findings suggest that maintaining high levels of skeletal muscle mass, muscular strength, and anaerobic power from relatively young age may lower AIx.


2020 ◽  
Vol 45 (6) ◽  
pp. 969-981
Author(s):  
Xi Xiao ◽  
Chunyan Yi ◽  
Yuan Peng ◽  
Hongjian Ye ◽  
Haishan Wu ◽  
...  

<b><i>Background:</i></b> Serum uric acid (SUA) has been revealed to be positively associated with the body composition parameters in hemodialysis patients, but few studies have investigated that in patients on peritoneal dialysis (PD). The aim of this study was to identify the relationship between SUA and appendicular skeletal muscle mass (ASM) and the effect of their interaction on mortality in PD patients. <b><i>Methods:</i></b> This was a single-center retrospective cohort study. Patients who underwent multifrequency bioelectrical impedance analysis between January 1, 2013, and December 31, 2016, and had data on SUA values were enrolled. All patients were followed up until December 31, 2019. <b><i>Results:</i></b> In total, 802 prevalent PD patients (57.9% male), with mean age of 46.2 ± 14.2 years were enrolled. The average SUA and ASM were 6.8 ± 1.3 mg/dL and 21.2 ± 4.9 kg. According to multiple linear regression models, SUA was positively associated with relative ASM in middle-aged and older PD patients (standardized coefficients [β] 0.117; 95% confidence interval [CI] 0.027, 0.200; <i>p</i> = 0.010). Further sex-stratified analysis showed that the association existed only in males (β 0.161; 95% CI 0.017, 0.227; <i>p</i> = 0.023). Moreover, the presence of hyperuricemia was found to predict lower risk of all-cause mortality (hazard ratio [HR] 0.514, 95% CI 0.272, 0.970; <i>p</i> = 0.040) only in patients with lower relative ASM. And, the adjusted HR of every 1 mg/dL elevated SUA level was 0.770 (95% CI 0.609, 0.972; <i>p</i> = 0.028) for all-cause mortality in the lower relative ASM subgroup. <b><i>Conclusions:</i></b> There exists a positive association between the SUA and ASM, and the ASM significantly affected the association between SUA and all-cause PD mortality.


Circulation ◽  
2006 ◽  
Vol 114 (2) ◽  
pp. 126-134 ◽  
Author(s):  
Massimo F. Piepoli ◽  
Agnieszka Kaczmarek ◽  
Darrel P. Francis ◽  
L. Ceri Davies ◽  
Mathias Rauchhaus ◽  
...  

2021 ◽  
Author(s):  
Tatsuya Igawa ◽  
Norihiro Isogai ◽  
Akifumi Suzuki ◽  
Masahiro Ishizaka ◽  
Haruki Funao ◽  
...  

Abstract Dropped head syndrome (DHS) exhibits cervical deformity due to weakness of the cervical extensor group, and sarcopenia is characterized by progressive and systemic reduction in skeletal muscle mass. These clinical finding are associated with reduced activity of daily living, reduced quality of life, and increased risk of mortality. We collected and reviewed prospective registry data for 16 consecutive female patients with idiopathic DHS and 32 healthy individuals who matched their gender and age. The prevalence of sarcopenia and body composition data were compared. There were no differences in the prevalence of sarcopenia, appendicular muscle mass, and leg muscle mass between DHS patients and the healthy elderly. Trunk muscle mass in DHS patients was significantly lower than that in healthy individuals. A significant correlation was found between appendicular muscle mass and trunk muscle mass in healthy subjects but not in DHS patients. Sarcopenia was not associated with the onset of idiopathic DHS. The prevalence of sarcopenia was not high in patients with idiopathic DHS due to the preservation of their appendicular skeletal muscle mass. Patients with DHS were characterized by a significant loss of trunk muscle mass that may be related to the disease but not aging.


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