Consolidating Concepts From Recent International Expert Consensus on Sarcopenia: Implications for Heart Failure Management.

Heart failure (HF) is a clinical syndrome associated with a range of pathophysiological disorders, including secondary sarcopenia that reduces patients' quality of life, mobility, physical fitness, and capacity to undergo rehabilitation and recovery from acute decompensation. Although international expert writing groups have convened and developed consensus documents for sarcopenia, the vast majority of the content has focused on the disorder from the aging perspective. HF is rarely or never considered in the available consensus statements and recommendations. Moreover, there are differences in the sarcopenia diagnostic criteria pertaining to race/ethnicity (translating into differences in body composition and anthropometry), investigative methodologies, practice patterns, and variations in access to health care resources across nations that are not discussed in the current HF-management guidelines. Here, we review the key contents of the recent major international consensus documents concerning sarcopenia that were published between 2019 and 2024. We highlight the gaps in knowledge (eg, sarcopenic obesity, cardiac atrophy/wasting) and recent developments in HF treatment (eg sodium glucose co-transporter 2 inhibitors) and interventions (eg, rehabilitation, inspiratory muscle training) that may benefit sarcopenia; and we reformulate the 4-step pathway of early screening, investigation, diagnosis and severity determination (Find-Assess-Confirm-Severity) for sarcopenia as a vital part of HF management under a multidisciplinary care team.