Clinical implications of severe sarcopenia in Japanese patients with acute heart failure

Abstract

AimSarcopenia is a geriatric condition characterized by progressive loss of skeletal muscle mass and function. The definition and diagnosis of sarcopenia is inconsistent between different populations and is still evolving. Herein, we investigated the prevalence and clinical implications of severe sarcopenia using the Asian Working Group for Sarcopenia (AWGS) 2019 criteria in Japanese patients with acute heart failure (HF).MethodsOverall, 272 patients admitted for acute HF were evaluated for sarcopenia using the AWGS 2019 criteria.ResultsThere were 46 patients with severe sarcopenia, accounting for approximately 75% of patients who were diagnosed as having sarcopenia. A Kaplan–Meier analysis showed that patients with severe sarcopenia had a higher incidence of cardiac death or rehospitalization for HF 1 year post‐discharge than those with non‐severe sarcopenia or without sarcopenia (log‐rank P = 0.006). A multivariate Cox regression analysis showed that severe sarcopenia was independently correlated with the occurrence of cardiac death or rehospitalization for HF after adjusting for other prognostic factors (hazard ratio 2.580, 95% confidence interval: 1.404–4.740, P = 0.002).ConclusionsSevere sarcopenia constituted most sarcopenia diagnoses using the AWGS 2019 cut‐off values, and was independently associated with 1‐year incidence of cardiac death or rehospitalization for HF post‐discharge in Japanese patients with acute HF. The assessment of sarcopenia may provide useful information for HF management. Geriatr Gerontol Int 2022; 22: 477–482.

Prevalence of Sarcopenia in Chronic Heart Failure and Modulating Role of Chronic Kidney Disease

“…When compared to patients hospitalized with acute HF, both the percentages of overall sarcopenia and severe sarcopenia were lower in our study [25]. This finding can be easily explained by the acute care (hospital) setting strong influence on the development of sarcopenia (acute disease, immobilization, food restrictions, etc.…”

Sarcopenia prognosis using dual‐energy X‐ray absorptiometry and prediction model in older patients with heart failure

“…In a clinical study of 272 hospitalized patients with acute heart failure, sarcopenia diagnosed using BIA was related to cardiac death or heart failure rehospitalization. 25 Moreover, we have already reported from FRAGILE‐HF that sarcopenia assessed using BIA was independently associated with 1 year mortality, irrespective of left ventricular ejection fraction. 7 However, no study has reported an association between sarcopenia defined using DEXA and prognosis, although DEXA may be superior to BIA in terms of its prognostic value in patients with heart failure.…”

“…The prognostic impact of sarcopenia has been reported in patients with heart failure, and previous studies have evaluated sarcopenia using BIA. In a clinical study of 272 hospitalized patients with acute heart failure, sarcopenia diagnosed using BIA was related to cardiac death or heart failure rehospitalization 25 . Moreover, we have already reported from FRAGILE‐HF that sarcopenia assessed using BIA was independently associated with 1 year mortality, irrespective of left ventricular ejection fraction 7 .…”

Usefulness of an early sarcopenia screening in predicting short-term mortality in older patients discharged for acute heart failure .

“…1, 229 patients hospitalized with acutely DHF were assessed for eligibility. Thirty-two patients were not included in the study due to in-hospital deaths (10), inability to participate (19), or refusal (3). Thus, 191 patients were nally enrolled, of whom 7 were lost to follow-up.…”

“…Patients with HF and sarcopenia are more prone to develop physical frailty and related negative health outcomes, with a higher risk of HF progression with the need for hospitalization [5] and an increased mortality rate [8,9]. Notwithstanding, very few studies have attempted to evaluate the shortterm prognostic signi cance of sarcopenia in older individuals with HF [10][11][12][13]. According to the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) guidelines [6], all patients with suspected sarcopenia should undergo the SARC-F, a 5-item questionnaire that is self-reported by patients based on their perception of limitations in strength, walking ability, rising from a chair, stair climbing, and experiences with falls.…”