Anagnostou Dimitrios, Theodorakis Nikolaos, Hitas Christos, Kreouzi Magdalini, Pantos Ioannis, Vamvakou Georgia, Nikolaou Maria
Department of Cardiology & 65+ Geriatric Outpatient Clinic, Amalia Fleming General Hospital, 14, 25th Martiou Str., 15127 Melissia, Greece.
School of Medicine, National and Kapodistrian University of Athens, 75 Mikras Asias, 11527 Athens, Greece.
Nutrients. 2025 Jan 14;17(2):282. doi: 10.3390/nu17020282.
Sarcopenia, an age-related decline in skeletal muscle mass, strength, and function, is increasingly recognized as a significant condition in the aging population, particularly among those with cardiovascular diseases (CVD). This review provides a comprehensive synthesis of the interplay between sarcopenia and cardiogeriatrics, emphasizing shared mechanisms such as chronic low-grade inflammation (inflammaging), hormonal dysregulation, oxidative stress, and physical inactivity. Despite advancements in diagnostic frameworks, such as the EWGSOP2 and AWGS definitions, variability in criteria and assessment methods continues to challenge standardization. Key diagnostic tools include dual-energy X-ray absorptiometry (DXA) and bioimpedance analysis (BIA) for muscle mass, alongside functional measures such as grip strength and gait speed. The review highlights the bidirectional relationship between sarcopenia and cardiovascular conditions such as heart failure, aortic stenosis, and atherosclerotic cardiovascular disease, which exacerbate each other through complex pathophysiological mechanisms. Emerging therapeutic strategies targeting the mTOR pathway, NAD+ metabolism, and senescence-related processes offer promise in mitigating sarcopenia's progression. Additionally, integrated interventions combining resistance training, nutritional optimization, and novel anti-aging therapies hold significant potential for improving outcomes. This paper underscores critical gaps in the evidence, including the need for longitudinal studies to establish causality and the validation of advanced therapeutic approaches in clinical settings. Future research should leverage multi-omics technologies and machine learning to identify biomarkers and personalize interventions. Addressing these challenges is essential to reducing sarcopenia's burden and enhancing the quality of life for elderly individuals with comorbid cardiovascular conditions. This synthesis aims to guide future research and promote effective, individualized management strategies.
肌肉减少症是一种与年龄相关的骨骼肌质量、力量和功能下降的病症，越来越被认为是老龄人口中的一种重要疾病，尤其是在患有心血管疾病（CVD）的人群中。本综述全面综合了肌肉减少症与老年心脏病学之间的相互作用，强调了诸如慢性低度炎症（炎症衰老）、激素失调、氧化应激和身体活动不足等共同机制。尽管在诊断框架方面取得了进展，如EWGSOP2和AWGS定义，但标准和评估方法的变异性仍然对标准化构成挑战。关键诊断工具包括用于测量肌肉质量的双能X射线吸收法（DXA）和生物电阻抗分析（BIA），以及诸如握力和步速等功能测量方法。该综述强调了肌肉减少症与心血管疾病如心力衰竭、主动脉瓣狭窄和动脉粥样硬化性心血管疾病之间的双向关系，这些疾病通过复杂的病理生理机制相互加剧。针对mTOR途径、NAD+代谢和衰老相关过程的新兴治疗策略有望减轻肌肉减少症的进展。此外，结合阻力训练、营养优化和新型抗衰老疗法的综合干预措施在改善治疗效果方面具有巨大潜力。本文强调了证据中的关键差距，包括需要进行纵向研究以确定因果关系以及在临床环境中验证先进治疗方法。未来的研究应利用多组学技术和机器学习来识别生物标志物并实现个性化干预。应对这些挑战对于减轻肌肉减少症的负担和提高患有合并心血管疾病的老年人的生活质量至关重要。本综述旨在指导未来的研究并促进有效、个性化的管理策略。
