Imamura Yasutaka, Suzuki Atsushi, Kamishima Kazuho, Suzuki Kazuhito, Yamaguchi Junichi
Department of Cardiology, Rissho Koseikai Kosei Hospital, Tokyo, Japan.
Department of Cardiology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.
Egypt Heart J. 2024 Apr 29;76(1):52. doi: 10.1186/s43044-024-00484-4.
Heart failure (HF) prevalence increases with age, and sarcopenia is a poor prognostic factor in patients with HF. We aimed to evaluate the characteristics and prognostic factors in patients with HF and sarcopenia.
We retrospectively reviewed 256 consecutive patients admitted to our hospital for HF between May 2018 and May 2021, underwent dual-energy X-ray absorptiometry, and were diagnosed with sarcopenia. The primary endpoint was all-cause mortality. The prognoses and characteristics were evaluated and compared between patients with left ventricular ejection fraction (LVEF) < 50% (reduced LVEF, HF with reduced ejection fraction [HFrEF]) and those with LVEF ≥ 50% (preserved LVEF, HF with preserved ejection fraction [HFpEF]). 83 (32%) and 173 (68%) patients had HFrEF and HFpEF, respectively. The HFrEF group had fewer women, lower hypertension rates, higher ischemic heart disease rates, and brain natriuretic peptide (BNP) levels than did the HFpEF group. Kaplan-Meier analysis for all-cause death showed that the HFrEF group had a significantly worse prognosis than the HFpEF group [log-rank p = 0.002].
In patients with HF and sarcopenia, older age, higher New York Heart Association (NYHA) class, BNP levels, and reduced LVEF were independent predictors of death after evaluation. During the treatment of patients with HF and sarcopenia, it is necessary to manage treatment with close attention to BNP and LVEF.
心力衰竭（HF）的患病率随年龄增长而增加，肌肉减少症是HF患者预后不良的因素。我们旨在评估HF合并肌肉减少症患者的特征和预后因素。
我们回顾性分析了2018年5月至2021年5月期间因HF入住我院并接受双能X线吸收法检查且被诊断为肌肉减少症的256例连续患者。主要终点是全因死亡率。对左心室射血分数（LVEF）<50%（LVEF降低，射血分数降低的心力衰竭[HFrEF]）和LVEF≥50%（LVEF保留，射血分数保留的心力衰竭[HFpEF]）的患者的预后和特征进行了评估和比较。分别有83例（32%）和173例（68%）患者患有HFrEF和HFpEF。与HFpEF组相比，HFrEF组女性较少，高血压发生率较低，缺血性心脏病发生率较高，脑钠肽（BNP）水平较高。全因死亡的Kaplan-Meier分析显示，HFrEF组的预后明显比HFpEF组差[对数秩p = 0.002]。
在HF合并肌肉减少症的患者中，年龄较大、纽约心脏协会（NYHA）分级较高、BNP水平较高和LVEF降低是评估后死亡的独立预测因素。在治疗HF合并肌肉减少症的患者时，有必要密切关注BNP和LVEF进行治疗管理。
