Donca Valer, Crişan Dana, Coada Camelia Alexandra, Stoicescu Laurenţiu, Buzdugan Elena, Grosu Alin, Lupu Mihai, Avram Lucreţia
Geriatrics-Gerontology, Department 5-Medical Specicalties, Faculty of Medicine, Iuliu Haţieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania.
Department of Internal Medicine, 5th Medical Clinic, Faculty of Medicine, Iuliu Haţieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania.
J Clin Med. 2025 Jun 16;14(12):4288. doi: 10.3390/jcm14124288.
To evaluate the individual and combined impact of sarcopenia (SARC) and heart failure (HF) on functional performance, systemic biomarkers, and structural cardiac changes in hospitalized older adults. A total of 598 patients aged ≥65 years admitted to a geriatric unit between January 2023 and December 2024, stratified into four groups based on the presence or absence of sarcopenia and HF. Muscle strength (handgrip), gait speed, SPPB score, and calf circumference were assessed, along with inflammatory/nutritional markers and echocardiographic parameters. Sarcopenia was diagnosed according to EWGSOP2 criteria and HF was diagnosed according to ESC 2021 guidelines. Functional impairment was the most severe in the SARC+/HF+ group, with significantly lower handgrip strength, gait speed, and SPPB scores ( < 0.001). Sarcopenia alone was associated with greater functional decline than HF alone. Serum hemoglobin and albumin levels were reduced in sarcopenic groups, while NT-proBNP and cardiac remodeling indices (IVS and LVEDD) were highest in patients with both conditions. Sarcopenia exerts a significant impact on physical performance in older adults, surpassing that of HF in isolation. The coexistence of sarcopenia and HF amplifies vulnerability and clinical decline, supporting the need for integrated assessment and early muscle-targeted interventions in geriatric cardiology.
评估肌肉减少症（SARC）和心力衰竭（HF）对住院老年人功能表现、全身生物标志物及心脏结构变化的个体及联合影响。2023年1月至2024年12月期间，共有598名年龄≥65岁的患者入住老年病房，根据是否存在肌肉减少症和心力衰竭分为四组。评估肌肉力量（握力）、步速、简易体能状况量表（SPPB）评分和小腿围，以及炎症/营养标志物和超声心动图参数。根据欧洲老年人肌肉减少症工作组（EWGSOP2）标准诊断肌肉减少症，根据欧洲心脏病学会（ESC）2021年指南诊断心力衰竭。在肌肉减少症阳性/心力衰竭阳性组中，功能障碍最为严重，握力、步速和SPPB评分显著降低（<0.001）。单纯肌肉减少症比单纯心力衰竭与更大的功能衰退相关。肌肉减少症组血清血红蛋白和白蛋白水平降低，而N末端脑钠肽前体（NT-proBNP）和心脏重构指数（室间隔厚度和左心室舒张末期内径）在两种情况并存的患者中最高。肌肉减少症对老年人的身体表现有显著影响，超过单纯心力衰竭的影响。肌肉减少症和心力衰竭并存会增加脆弱性和临床衰退，支持在老年心脏病学中进行综合评估和早期针对肌肉的干预措施的必要性。
