New diagnostic index for sarcopenia in patients with cardiovascular diseases

Abstract

BackgroundSarcopenia is an aging and disease-related syndrome characterized by progressive and generalized loss of skeletal muscle mass and strength, with the risk of frailty and poor quality of life. Sarcopenia is diagnosed by a decrease in skeletal muscle index (SMI) and reduction of either handgrip strength or gait speed. However, measurement of SMI is difficult for general physicians because it requires special equipment for bioelectrical impedance assay or dual-energy X-ray absorptiometry. The purpose of this study was, therefore, to explore a novel, simple diagnostic method of sarcopenia evaluation in patients with cardiovascular diseases (CVD).MethodsWe retrospectively investigated 132 inpatients with CVD (age: 72±12 years, age range: 27–93 years, males: 61%) Binomial logistic regression and correlation analyses were used to assess the associations of sarcopenia with simple physical data and biomarkers, including muscle-related inflammation makers and nutritional markers.ResultsSarcopenia was present in 29.5% of the study population. Serum concentrations of adiponectin and sialic acid were significantly higher in sarcopenic than non-sarcopenic CVD patients. Stepwise multivariate binomial logistic regression analysis revealed that adiponectin, sialic acid, sex, age, and body mass index were independent factors for sarcopenia detection. Sarcopenia index, obtained from the diagnostic regression formula for sarcopenia detection including the five independent factors, indicated a high accuracy in ROC curve analysis (sensitivity 94.9%, specificity 69.9%) and the cutoff value for sarcopenia detection was -1.6134. Sarcopenia index had a significant correlation with the conventional diagnostic parameters of sarcopenia.ConclusionsOur new sarcopenia index using simple parameters would be useful for diagnosing sarcopenia in CVD patients.

Handgrip Strength in Preoperative Elective Cardiac Surgery Patients and Association With Body Composition and Surgical Risk

“…Guidelines of the American Heart Association and the American College of Cardiology consider frailty an important factor in determining risk in valve replacement surgeries . Sarcopenia (a syndrome involving the progressive and generalized loss of skeletal muscle mass, muscle strength, and function) is prevalent in 29.5% of patients with cardiovascular disease, increasing the risk of frailty, which impacts outcomes such as longer hospitalization time and higher mortality rates …”

“…10 Guidelines of the American Heart Association and the American College of Cardiology consider frailty an important factor in determining risk in valve replacement surgeries. 7 Sarcopenia (a syndrome involving the progressive and generalized loss of skeletal muscle mass, muscle strength, and function) is prevalent in 29.5% of patients with cardiovascular disease, 11 increasing the risk of frailty, which impacts outcomes such as longer hospitalization time and higher mortality rates. 12 Frailty scores (given by a 4.5m walk test, Katz activities of daily living, preoperative serum albumin level, and dominant handgrip strength [HGS]), 13 as well as individual components of the frailty score, are independent predictors of poor post-transcatheter aortic valve replacement (TAVR) outcomes, including all-cause mortality.…”

Bridging gaps in heart valve disease care: Opportunities for quality improvement

“…The EuroSCORE II and the STS score are widely supported as the preferred operative risk assessment instruments . Other evidence‐supported tools that help clinicians assess risks associated with cardiovascular treatment options include: Survival post TAVI score Sarcopenia Multidimensional geriatric assessment tools: gait speed and grip strength Norton scale Ambler score TAVR in‐hospital mortality risk calculator Patient decision aids : The national valvular heart disease guidelines recommend a shared decision‐making approach. Several research studies recommend the use of decision‐making tools to help patients select treatment options .…”

Gain in adiposity over 3 years is associated with progressive renal decline in multi‐ethnic South‐east Asians with type 2 diabetes

“…Electrodes were placed in a tetrapolar configuration on the body and a weak alternating electric current of constant amplitude and high frequency (1, 5, 50, 250, 500, and 1000 kHz) was applied through current electrodes and the voltage detected through sensing electrodes. Based on these impedance values, visceral fat area (VFA), body fat mass, and skeletal muscle mass were computed using the manufacturer's undisclosed proprietary equations . Creatinine was measured using an enzymatic method on the Roche/Hitachi cobas c system (Roche Diagnostic, Mannheim, Germany).…”

“…Based on these impedance values, visceral fat area (VFA), body fat mass, and skeletal muscle mass were computed using the manufacturer's undisclosed proprietary equations. [12][13][14] Creatinine was measured using an enzymatic method on the Roche/ Hitachi cobas c system (Roche Diagnostic, Mannheim, Germany). The eGFR was derived using the Chronic Kidney Disease Epidemiology Collaboration equation.…”