Association between inflammation and skeletal muscle proteolysis, skeletal mass and strength in elderly heart failure patients and their prognostic implications

Abstract

Background Inflammation and skeletal muscle wasting often coexist in elderly populations, but few studies have examined their relationship in elderly heart failure (HF) patients. This study examined the relationship between inflammation and increased skeletal muscle proteolysis, reduced skeletal mass and strength, and their prognostic implications in elderly HF patients (> 65 years) using a random forest approach. Methods We prospectively enrolled consecutive elderly HF patients (n = 78) and age- and sex-matched control subjects (n = 83). We measured the interleukin (IL)-6, C-reactive protein (CRP), and B-type natriuretic peptide (BNP) levels, lower limb muscle mass and strength, and 6-min walk distance. The amount of muscle proteolysis was determined by urinary 3-methylhystidine, normalized by creatinine (3-MH/Cr). The composite endpoint was defined as all-cause death or hospitalizations due to worsening HF. Results Compared to controls, elderly HF patients had a significantly higher IL-6, CRP, BNP, and 3-MH/Cr, and exhibited a reduced lower limb muscle mass and strength. A correlation analysis demonstrated significant positive correlations between the inflammatory cytokine levels and 3-MH/Cr and BNP, and negative correlations with the lower limb muscle mass and strength, and 6-min walk distance. During a median follow-up of 2.4-years, 24 patients reached the endpoint. A random forest model revealed that inflammatory cytokines, skeletal muscle wasting, and the BNP had greater effects on the risk prediction. The algorithm achieved an area under the receiver operating characteristic curve of 0.887 (95% CI, 0.772–1.000). Conclusion This study provided evidence of the association between inflammation and increased skeletal muscle proteolysis, reduced skeletal mass and strength, and their prognostic roles in elderly HF patients.

Sarcopenia in Non-Dialysis Chronic Kidney Disease Patients: Prevalence and Associated Factors

“…Sarcopenia is a generalized and progressive disorder of skeletal muscle mass and is related to increased risk of adverse outcomes such as falls, fractures, physical frailty, and mortality in CKD patients ( 6 , 23 , 24 ). However, few studies had investigated the impact of PhA, Inflammatory Cytokines and ARBs-blockers, and sarcopenia prevalence in ND-CKD patients.…”

Levels of Interleukin-6 in Saliva, but Not Plasma, Correlate with Clinical Metrics in Huntington’s Disease Patients and Healthy Control Subjects

“…Studies have shown that HD skeletal muscle is hyperexcitable, which can cause involuntary and prolonged contractions that may contribute to chorea [ 27 ] and could produce elevated levels of IL-6. However, it is also known that chronically elevated IL-6 production can promote skeletal muscle wasting [ 28 , 29 ] and muscular atrophy [ 30 ]. In addition to the general skeletal muscle dysfunction occurring in HD [ 5 , 31 , 32 , 33 ], skeletal muscle wasting and/or atrophy is likely to represent a significant component of HD pathogenesis [ 31 ].…”

High Intensity Interval Training Leads to Similar Inflammatory Activation as Seen With Traditional Training in Chronic Heart Failure

“…Inflammatory activation with increased plasma/serum cytokine levels has been described as an important factor for the progression of chronic heart failure (CHF) (1,2). Cytokines appear to act as catabolic factors in the pathogenesis of skeletal muscle wasting and cardiac cachexia (3)(4)(5). This has important implications as muscle mass is an important determinant of exercise and functional capacity (6).…”

“…This has important implications as muscle mass is an important determinant of exercise and functional capacity ( 6 ). Moreover, the progressive loss of muscle mass, cachexia (i.e., weight loss due to an underlying illness), and low levels of muscular strength are strong predictors of the risk for premature mortality ( 5 , 7 , 8 ). Emerging research has demonstrated the important relationship between cytokines, health, and cardiovascular fitness.…”