Kılıç Raif, Güzel Tuncay, Aktan Adem, Güzel Hamdullah, Kaya Ahmet Ferhat, Arslan Bayram, Demirci Murat, Çankaya Yusuf, Karahan Mehmet Zülküf
Department of Cardiology, Çermik State Hospital, Diyarbakır, Turkey.
Department of Cardiology, Health Science University, Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey.
Acta Cardiol. 2024 Oct;79(8):915-923. doi: 10.1080/00015385.2024.2410604. Epub 2024 Oct 8.
Sarcopenia is a progressive age-related skeletal muscle disease associated with adverse outcomes in those with cardiovascular disease. In this study, the prevalence of sarcopenia and its effect on clinical outcomes in heart failure with mildly reduced ejection fraction (HFmrEF) patients were examined.
A total of 722 patients from three centres who applied to the outpatient clinic with the diagnosis of HFmrEF between 01 January 2020 and 01 June 2021 were included in the study retrospectively. Sarcopenia was diagnosed with a screening test using age, grip srength and calf circumference. At least two-year follow-up results were reviewed from the date the patients were included in the study.
Of the 722 HFmrEF patients, 169 (23.4%) were sarcopenic. During the follow-up of sarcopenic patients, a higher rate of hospitalisation and two-year mortality was detected compared to the non-sarcopenic group (49.7% vs 33.3%, < .001 and 23.7% vs 13.2%, = .001, respectively). Additionally, atrial fibrillation (AF), chronic obstructive pulmonary disease (COPD), chronic renal failure (CRF) and smoking were detected at higher rates in sarcopenic patients. In subgroup analysis, AF was found to be significantly higher in overweight/obese sarcopenia patients compared to other groups. According to Receiver operating characteristic (ROC) analysis, the sarcopenia score cut-off of 73.61 predicted mortality with 65% sensitivity and 63% specificity, and the cut-off level of 71.10 predicted hospitalisation with 68% sensitivity and 69% specificity.
In HFmrEF patients, sarcopenia is associated with adverse events and is an important prognostic marker.
肌肉减少症是一种与年龄相关的进行性骨骼肌疾病，与心血管疾病患者的不良预后相关。在本研究中，我们调查了肌肉减少症在射血分数轻度降低的心力衰竭（HFmrEF）患者中的患病率及其对临床结局的影响。
本研究回顾性纳入了2020年1月1日至2021年6月1日期间在三个中心门诊诊断为HFmrEF的722例患者。采用年龄、握力和小腿围度的筛查试验诊断肌肉减少症。从患者纳入研究之日起回顾至少两年的随访结果。
722例HFmrEF患者中，169例（23.4%）存在肌肉减少症。在肌肉减少症患者的随访期间，与非肌肉减少症组相比，住院率和两年死亡率更高（分别为49.7%对33.3%，P<0.001；23.7%对13.2%，P=0.001）。此外，肌肉减少症患者中房颤（AF）、慢性阻塞性肺疾病（COPD）、慢性肾衰竭（CRF）和吸烟的发生率更高。在亚组分析中，超重/肥胖的肌肉减少症患者中房颤的发生率明显高于其他组。根据受试者工作特征（ROC）分析，肌肉减少症评分临界值为73.61时预测死亡率的灵敏度为65%，特异度为63%；临界值为71.10时预测住院率的灵敏度为68%，特异度为69%。
在HFmrEF患者中，肌肉减少症与不良事件相关，是一个重要的预后标志物。
