Solla-Suarez Pablo, Avanzas Pablo, Encuentra-Sopena Marta, Almendárez Marcel, Álvarez-Abella Áurea, Álvarez-Velasco Rut, Domingo-Lavandera Fe, Boga José, Coto-Montes Ana, de la Tassa César Morís, Gutiérrez-Rodríguez José
Geriatrics Department, Geriatrics Clinical Management Area, Monte Naranco Hospital-Central University Hospital of Asturias, Avenida Doctores Fernández Vega, 107, 33012, Oviedo, Asturias, Spain.
Health Research Institute of Asturias, ISPA, Oviedo, Spain.
Eur Geriatr Med. 2024 Dec;15(6):1645-1656. doi: 10.1007/s41999-024-01042-6. Epub 2024 Sep 4.
Muscle ultrasound is increasingly popular thanks to its advantages over other techniques. However, its usefulness in the diagnosis of sarcopenia in older adults with aortic stenosis (AS) has not been studied to date.
to analyze the prevalence of sarcopenia using muscle ultrasound and its impact on the health outcomes in older patients with AS.
The single-center FRESAS (FRailty-Evaluation-in-Severe-Aortic-Stenosis) registry was used to study patients over 75 years with severe AS susceptible to valve replacement. Sarcopenia was suspected in those individuals with diminished grip strength, and the diagnosis was confirmed in the presence of reduced ultrasound quadriceps muscle thickness, following the recommendations of the EWGSOP2 (European-Working-Group-on-Sarcopenia-in-Older-People). The primary composite endpoint was urgent hospital admission and mortality of cardiac cause 6 months after the diagnosis.
Of the 150 patients studied, 55.3% were females, and only 17.3% were frail; the mean age was 83.4 years. Sarcopenia was diagnosed in 42 patients (28%). The overall survival rate at 6 months was 92%. The primary endpoint was recorded in 23.2% of the cases and was more frequent in the sarcopenic patients (33.3%) than in the non-sarcopenic individuals (17.6%) (p = 0.01). The regression analysis found that sarcopenia was associated with an increased risk of the primary endpoint (HR: 2.25; 95% CI 1.19-4.45; p = 0.02), adjusting for potential confounding factors.
The incidence of serious cardiac complications in older patients with sarcopenia and severe AS is significant. The present study describes a noninvasive, ultrasound-guided diagnostic technique that may prove efficient in its predictive capacity.
由于肌肉超声相较于其他技术具有优势，其应用越来越广泛。然而，迄今为止，尚未研究其在诊断老年主动脉瓣狭窄（AS）患者肌肉减少症方面的效用。
分析使用肌肉超声诊断肌肉减少症的患病率及其对老年AS患者健康结局的影响。
采用单中心FRESAS（严重主动脉瓣狭窄中的虚弱评估）登记研究75岁以上易患瓣膜置换的严重AS患者。对于握力减弱的个体怀疑有肌肉减少症，按照欧洲老年人肌肉减少症工作组（EWGSOP2）的建议，在超声测量的股四头肌厚度降低时确诊。主要复合终点是诊断后6个月的紧急住院和心脏原因导致的死亡。
在研究的150例患者中，55.3%为女性，仅有17.3%为虚弱患者；平均年龄为83.4岁。42例患者（28%）被诊断为肌肉减少症。6个月时的总生存率为92%。23.2%的病例记录了主要终点，肌肉减少症患者（33.3%）比非肌肉减少症患者（17.6%）更常见（p = 0.01）。回归分析发现，在调整潜在混杂因素后，肌肉减少症与主要终点风险增加相关（HR：2.25；95%CI 1.19 - 4.45；p = 0.02）。
患有肌肉减少症和严重AS的老年患者发生严重心脏并发症的发生率较高。本研究描述了一种非侵入性的、超声引导的诊断技术，其预测能力可能被证明是有效的。
