Armentaro Giuseppe, Cassano Velia, Magurno Marcello, Pastura Carlo Alberto, Divino Marcello, Severini Giandomenico, Martire Domenico, Miceli Sofia, Maio Raffaele, Mazza Elisa, Montalcini Tiziana, Pujia Arturo, Sciacqua Angela
Geriatrics Division, "Renato Dulbecco" University Hospital of Catanzaro, 88100, Catanzaro, Italy.
Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, 88100, Catanzaro, Italy.
Aging Clin Exp Res. 2025 May 19;37(1):158. doi: 10.1007/s40520-025-03049-w.
Sarcopenia is common in patients with heart failure (HF) and it is frequently associated with other comorbidities. Sarcopenia has been linked to an increased risk of major adverse cardiovascular events (MACE) in HF patients.
The aim of the present study was to evaluate, in a cohort of older adult's patients affected by HF with reduced ejection fraction (HFrEF) and sarcopenia, already being treated with sacubitril/valsartan, the effect of add-on therapy with SGLT2i on clinical, functional abilities, muscle performance and effects on quality of life.
We enrolled 147 outpatients. A simple linear regression analysis was performed to assess the correlation between the change in Cardiac Index (CI) and Short physical performance battery (SPPB) values, expressed as (Δ) between baseline and follow-up (ΔT0-12), and several covariates.
After 12 months of treatment, we observed an improvement in the inflammatory profile, moreover there was a reduction of the oxidative stress (p < 0.0001) and platelets activation (p < 0.0001) parameters. In addition, there was a significant increase in CI and global longitudinal strain and a statistically significant improvement in cognitive function, as shown by Mini-Mental State examination (MMSE) (p < 0.0001) score and SPPB (p < 0.0001). Considering ΔCI as dependent variation, Δ8-isoprotane resulted the major predictor, justifying 13.3% of its variation. When ΔSPPB was considered as dependent variable, Δ8-Isoprostane was the main predictor of ΔSPPB, justifying 54.6% of its variation.
This study demonstrated that the addition of SGLT2i to therapy leads to improvements in echocardiographic and sarcopenia-related parameters and biomarkers of oxidative stress and platelet activation.
肌肉减少症在心力衰竭（HF）患者中很常见，且常与其他合并症相关。肌肉减少症与HF患者发生主要不良心血管事件（MACE）的风险增加有关。
本研究的目的是评估在一组射血分数降低的心力衰竭（HFrEF）和肌肉减少症的老年患者中，在已接受沙库巴曲/缬沙坦治疗的基础上，加用钠-葡萄糖协同转运蛋白2抑制剂（SGLT2i）对临床、功能能力、肌肉性能以及生活质量的影响。
我们纳入了147名门诊患者。进行简单线性回归分析，以评估心脏指数（CI）变化与短身体性能测试（SPPB）值之间的相关性，SPPB值以基线和随访（ΔT0-12）之间的差值（Δ）表示，以及几个协变量。
治疗12个月后，我们观察到炎症指标有所改善，此外氧化应激参数（p < 0.0001）和血小板活化参数（p < 0.0001）有所降低。此外，CI和整体纵向应变显著增加，认知功能有统计学意义的改善，如简易精神状态检查表（MMSE）评分（p < 0.0001）和SPPB（p < 0.0001）所示。将ΔCI作为因变量时，Δ8-异前列腺素是主要预测因子，可解释其13.3%的变化。当将ΔSPPB视为因变量时，Δ8-异前列腺素是ΔSPPB的主要预测因子，可解释其54.6%的变化。
本研究表明，在治疗中加用SGLT2i可改善超声心动图和与肌肉减少症相关的参数，以及氧化应激和血小板活化的生物标志物。
