Progressive loss of skeletal muscle termed “sarcopenia” is an independent risk factor for mortality in patients with cardiovascular diseases. A simple screening test that can identify sarcopenia using three variables (age, grip strength and calf circumference) was recently developed. We evaluated the clinical utility of this screening test in patients with heart failure (HF).
Methods and results
HF patients were divided into the sarcopenia (n = 82) and non-sarcopenia (n = 37) groups based on the sarcopenia score. Circulating BNP and high-sensitive cardiac troponin T levels were significantly higher, and left ventricular ejection fraction was lower in the sarcopenia group than non-sarcopenia group. Kaplan–Meier curve showed that HF event-free survival rate was significantly lower in the sarcopenia group. Multivariate Cox proportional hazards analysis identified BNP (ln[BNP]) (hazard ratio [HR]: 1.58; 95% CI: 1.09–2.29, p = 0.02), hs-CRP (ln[CRP]) (HR: 1.82; 95% CI: 1.23–2.68; p < 0.01) and sarcopenia score (HR: 1.03; 95% CI: 1.01–1.05, p < 0.01) as independent predictors of HF events. In receiver operating characteristic analysis, adding the sarcopenia score to BNP levels increased an area under the curve for future HF events (sarcopenia score alone, 0.77; BNP alone, 0.82; combination, 0.89).
The sarcopenia screening test can be used to predict future adverse events in patients with HF.
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- Wasting as independent risk factor for mortality in chronic heart failure.Lancet. 1997; 349: 1050-1053
- Thigh circumference and risk of heart disease and premature death: prospective cohort study.BMJ. 2009; 339: b3292
- Muscle strength as a predictor of long-term survival in severe congestive heart failure.Eur. J. Heart Fail. 2004; 6: 101-107
- Reduced handgrip strength as a marker of frailty predicts clinical outcomes in patients with heart failure undergoing ventricular assist device placement.J. Card. Fail. 2014; 20: 310-315
- Handgrip strength as a predictor of prognosis in Japanese patients with congestive heart failure.Eur. J. Cardiovasc. Prev. Rehabil. 2009; 16: 21-27
- Combined endurance/resistance training reduces nt-probnp levels in patients with chronic heart failure.Eur. Heart J. 2004; 25: 1797-1805
- Long-term effects of a group-based high-intensity aerobic interval-training program in patients with chronic heart failure.Am. J. Cardiol. 2008; 102: 1220-1224
- Effects of group-based high-intensity aerobic interval training in patients with chronic heart failure.Am. J. Cardiol. 2008; 102: 1361-1365
- Superior cardiovascular effect of aerobic interval training versus moderate continuous training in heart failure patients: a randomized study.Circulation. 2007; 115: 3086-3094
- Resistance exercise in individuals with and without cardiovascular disease: 2007 update: a scientific statement from the American Heart Association Council on Clinical Cardiology and Council on Nutrition, Physical Activity, and Metabolism.Circulation. 2007; 116: 572-584
- Sarcopenia.J. Lab. Clin. Med. 2001; 137: 231-243
- Muscle wasting in disease: molecular mechanisms and promising therapies.Nat. Rev. Drug Discov. 2015; 14: 58-74
- Understanding sarcopenia as a geriatric syndrome.Curr. Opin. Clin. Nutr. Metab. Care. 2010; 13: 1-7
- Sarcopenia evaluated by fat-free mass index is an important prognostic factor in patients with chronic heart failure.Eur. J. Intern. Med. 2015; 26: 118-122
- Sarcopenia: European consensus on definition and diagnosis: report of the European working group on sarcopenia in older people.Age Ageing. 2010; 39: 412-423
- Development of a simple screening test for sarcopenia in older adults.Geriatr. Gerontol. Int. 2014; 14: 93-101
- ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2012. The task force for the diagnosis and treatment of acute and chronic heart failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC.Eur. Heart J. 2012; 33: 1787-1847
- Calf circumference as a surrogate marker of muscle mass for diagnosing sarcopenia in Japanese men and women.Geriatr. Gerontol. Int. 2014; 15: 969-976
- Comments on “the management of heart failure with preserved ejection fraction”.Int. Cardiovasc. Forum J. 2014; 1: 166
- The management of heart failure with preserved ejection fraction (HFpEF).Int. Cardiovasc. Forum J. 2014; 1: 108-112
- Relationship between obesity and b-type natriuretic peptide levels.Arch. Intern. Med. 2004; 164: 2247-2252
- Natriuretic peptide-dependent lipolysis in fat cells is a primate specificity.Am. J. Physiol. Regul. Integr. Comp. Physiol. 2002; 283: 257-265
- Akt1-mediated skeletal muscle growth attenuates cardiac dysfunction and remodeling after experimental myocardial infarction.Circ. Heart Fail. 2012; 5: 116-125
- Fgf21 is an akt-regulated myokine.FEBS Lett. 2008; 582: 3805-3810
- Follistatin-like 1 is an akt-regulated cardioprotective factor that is secreted by the heart.Circulation. 2008; 117: 3099-3108
- Follistatin-like 1, a secreted muscle protein, promotes endothelial cell function and revascularization in ischemic tissue through a nitric-oxide synthase-dependent mechanism.J. Biol. Chem. 2008; 283: 32802-32811
Published online: April 17, 2016
Accepted: April 15, 2016
Received in revised form: April 12, 2016
Received: March 8, 2016
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