Lu Jinmei, Gao Yi, Zhou Lingbo, Peng Xinhui, Feng Haiming, Zheng Zaixing
Department of Critical Care Medicine, Ningbo Medical Center Li Huili Hospital, Ningbo, Zhejiang, China.
Department of Cardiology, Ningbo No. 2 Hospital, Ningbo, Zhejiang, China.
Front Med (Lausanne). 2025 Jul 21;12:1599572. doi: 10.3389/fmed.2025.1599572. eCollection 2025.
To perform a systematic review and meta-analysis evaluating the impact of sarcopenia-defined by reductions in muscle mass, strength, and/or function-on clinical outcomes in patients with heart failure (HF), thereby informing more effective management strategies.
A comprehensive literature search was conducted through 14 February 2025, using PubMed, Embase, Cochrane Library, and CNKI to identify prospective and retrospective cohort studies involving HF patients diagnosed with sarcopenia based on Asian Working Group for Sarcopenia (AWGS), European Working Group on Sarcopenia in Older People (EWGSOP2), or Ishii criteria. Data extraction was performed using standardized forms, and study quality was assessed using the Newcastle-Ottawa Scale (NOS). Meta-analytical procedures, including heterogeneity assessment and subgroup analyses, were carried out in Stata 18.0 and R 4.4.2.
Fifteen studies comprising 5,713 HF patients were included. Pooled analysis demonstrated that sarcopenia significantly increased the risk of adverse clinical outcomes [hazard ratio (HR) = 1.62, 95% confidence interval (CI): 1.35-1.89], including all-cause mortality (HR = 1.89, 95% CI: 1.63-2.15) and major adverse cardiovascular events (HR = 1.37, 95% CI: 1.11-1.64). Subgroup analyses revealed that sarcopenia defined by AWGS criteria and the Ishii score was significantly associated with worse outcomes (HR = 1.63, 95% CI: 1.33-1.94; HR = 1.78, 95% CI: 1.29-2.27, respectively), whereas definitions based on EWGSOP2 did not reach statistical significance (HR = 1.87, 95% CI: 0.70-3.05). Sarcopenia identified through DXA or BIA-based muscle mass assessments was also significantly correlated with adverse outcomes (DXA: HR = 1.53, 95% CI: 1.29-1.78; BIA: HR = 1.85, 95% CI: 1.10-2.61). Statistically significant associations were observed across all remaining subgroups.
Sarcopenia, when defined using multidimensional criteria, is significantly associated with poor clinical outcomes in patients with HF. These findings underscore the importance of implementing comprehensive sarcopenia assessments to enhance prognostic evaluation and guide early intervention. Clinically, adopting multidimensional diagnostic approaches can improve risk stratification and optimize the management of HF patients.
https://inplasy.com/inplasy-2025-3-0023/, identifier INPLASY202530023.
进行一项系统评价和荟萃分析，评估肌肉减少症（通过肌肉量、力量和/或功能的降低来定义）对心力衰竭（HF）患者临床结局的影响，从而为更有效的管理策略提供依据。
通过2025年2月14日进行全面的文献检索，使用PubMed、Embase、Cochrane图书馆和中国知网，以识别基于亚洲肌肉减少症工作组（AWGS）、欧洲老年人肌肉减少症工作组（EWGSOP2）或石井标准诊断为肌肉减少症的HF患者的前瞻性和回顾性队列研究。使用标准化表格进行数据提取，并使用纽卡斯尔-渥太华量表（NOS）评估研究质量。在Stata 18.0和R 4.4.2中进行荟萃分析程序，包括异质性评估和亚组分析。
纳入了15项研究，共5713例HF患者。汇总分析表明，肌肉减少症显著增加了不良临床结局的风险[风险比（HR）=1.62，95%置信区间（CI）：1.35-1.89]，包括全因死亡率（HR = 1.89，95% CI：1.63-2.15）和主要不良心血管事件（HR = 1.37，95% CI：1.11-1.64）。亚组分析显示，根据AWGS标准和石井评分定义的肌肉减少症与更差的结局显著相关（HR = 1.63，95% CI：1.33-1.94；HR = 1.78，95% CI：1.29-2.27），而基于EWGSOP2的定义未达到统计学意义（HR = 1.87，95% CI：0.70-3.05）。通过基于双能X线吸收法（DXA）或生物电阻抗分析（BIA）的肌肉量评估确定的肌肉减少症也与不良结局显著相关（DXA：HR = 1.53，95% CI：1.29-1.78；BIA：HR = 1.85，95% CI：1.10-2.61）。在所有其余亚组中均观察到具有统计学意义的关联。
当使用多维标准定义时，肌肉减少症与HF患者的不良临床结局显著相关。这些发现强调了实施全面的肌肉减少症评估以加强预后评估和指导早期干预的重要性。临床上，采用多维诊断方法可以改善风险分层并优化HF患者的管理。
https://inplasy.com/inplasy-2025-3-0023/，标识符INPLASY202530023 。
