Department of Rehabilitation, Faculty of Rehabilitation, Hiroshima International University, Kurose-Gakuendai 555-36, Higashi-Hiroshima, Hiroshima, Japan.
Department of Rehabilitation, Kure Kyosai Hospital, Nishichuo 2-3-28, Kure, Hiroshima, Japan.
Heart Vessels. 2022 Aug;37(8):1380-1386. doi: 10.1007/s00380-022-02046-7. Epub 2022 Mar 1.
In patients with heart failure, it is unknown whether the extracellular water (ECW)/intracellular water (ICW) ratio is associated with muscle strength, and thus, it is not well understood whether poor muscle quality contributes to muscular weakness. This study examined the relationship among hand grip strength, skeletal muscle mass index (SMI), and upper limb ECW/ICW ratio in patients with heart failure. This study followed a cross-sectional design. Demographic data, medical information, and hand grip strength were collected. The SMI and ECW/ICW ratio were measured using bio-impedance analysis (BIA). Hierarchical multiple regression analysis was conducted to identify factors associated with hand grip strength. 51 patients with heart failure were analyzed for this study (mean age 84.58 ± 7.18). Hierarchical multiple regression analysis identified SMI as well as upper limb ECW/ICW ratio as factors associated with hand grip strength, independent of age, sex, body mass index, and Life Space Assessment scores. Standardized partial regression coefficients representing the magnitude of involvement of each independent variable were 0.33 and - 0.16. The coefficient of determination adjusted for degrees of freedom (R), representing the contribution rate of the regression equation, was 0.830. We revealed that loss of hand grip strength in patients with heart failure is associated with not only with a decrease in skeletal muscle mass, but also with a decline in muscle quality, characterized by an increased upper limb ECW/ICW ratio. BIA is a simple and useful method to measure the ECW/ICW ratio, and in turn, the muscle quality, in patients with heart failure.
在心力衰竭患者中，细胞外液（ECW）/细胞内液（ICW）比值与肌肉力量的关系尚不清楚，因此，肌肉质量差是否导致肌肉无力尚不清楚。本研究探讨了心力衰竭患者手握力、骨骼肌质量指数（SMI）和上肢 ECW/ICW 比值之间的关系。本研究采用横断面设计。收集人口统计学数据、医学信息和手握力。使用生物阻抗分析（BIA）测量 SMI 和 ECW/ICW 比值。采用分层多元回归分析确定与手握力相关的因素。本研究分析了 51 例心力衰竭患者（平均年龄 84.58±7.18 岁）。分层多元回归分析确定 SMI 以及上肢 ECW/ICW 比值是与手握力相关的因素，独立于年龄、性别、体重指数和生活空间评估评分。代表每个自变量参与程度的标准化偏回归系数分别为 0.33 和-0.16。代表回归方程贡献率的自由度调整后的决定系数（R）为 0.830。我们揭示了心力衰竭患者手握力的丧失不仅与骨骼肌质量的减少有关，而且还与肌肉质量的下降有关，其特征是上肢 ECW/ICW 比值增加。BIA 是一种简单而有用的方法，可以测量心力衰竭患者的 ECW/ICW 比值，进而测量肌肉质量。
