Sarcopenia in adults with congenital heart disease: Nutritional status, dietary intake, and resistance training

Shiina, Yumi; Matsumoto, Noriko; Okamura, Daisuke; Takahashi, Yuta; Kijima, Yasufumi; Fukuda, Terunobu; Kawamatsu, Naoto; Nishihata, Yosuke; Komiyama, Nobuyuki; Niwa, Koichiro

doi:10.1016/j.jjcc.2019.01.003

Cited by 18 publications

(20 citation statements)

References 25 publications

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“…In spite of higher incidence of obese, some ACHD patients especially complex ACHD or cyanotic ACHD revealed sarcopenia. Following recent study on sarcopenia in ACHD,72) ACHD patients have higher calorie, protein, and fat intake than those in a national survey despite decreased skeletal muscle mass. Amino acid intake plus resistance training positively improved body fat percentage, skeletal muscle mass, and edema in ACHD.…”

Section: Risk Factors For Coronary Artery Disease and Metabolic Syndrmentioning

confidence: 99%

Metabolic Syndrome in Adult Congenital Heart Disease

Niwa

2019

Korean Circ J

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In adult congenital heart disease (ACHD), residua and sequellae after initial repair develop late complications such as cardiac failure, arrhythmias, thrombosis, aortopathy, pulmonary hypertension and others. Acquired lesions with aging such as hypertension, diabetes mellitus, obesity can be negative influence on original cardiovascular disease (CVD). Also, atherosclerosis may pose an additional health problem to ACHD when they grow older and reach the age at which atherosclerosis becomes clinically relevant. In spite of the theoretical risk of atherosclerosis in ACHD due to above mentioned factors, cyanotic ACHDs even after repair are noted to have minimal incidence of coronary artery disease (CAD). Acyanotic ACHD has similar prevalence of CAD as the general population. However, even in cyanotic ACHD, CAD can develop when they have several risk factors for CAD. The prevalence of risk factor is similar between ACHD and the general population. Risk of premature atherosclerotic CVD in ACHD is based, 3 principal mechanisms: lesions with coronary artery abnormalities, obstructive lesions of left ventricle and aorta such as coarctation of the aorta and aortopathy. Coronary artery abnormalities are directly affected or altered surgically, such as arterial switch in transposition patients, may confer greater risk for premature atherosclerotic CAD. Metabolic syndrome is more common among ACHD than in the general population, and possibly increases the incidence of atherosclerotic CAD even in ACHD in future. Thus, ACHD should be screened for metabolic syndrome and eliminating risk factors for atherosclerotic CAD.

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Section: Risk Factors For Coronary Artery Disease and Metabolic Syndrmentioning

confidence: 99%

Metabolic Syndrome in Adult Congenital Heart Disease

Niwa

2019

Korean Circ J

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“…Secondary sarcopenia is not rare in adult patients with CHD as mentioned above [10], although they are relatively young when compared to non-CHD adults with HF. The possible reasons for secondary sarcopenia in Fontan patients are the following: (1) inappropriate nutritional intake and unhealthy/non-active lifestyle, (2) absence of regular exercise since childhood, (3) poor absorption due to gastrointestinal edema, (4) hypercatabolism, (5) hormonal imbalances, (6) inflammatory processes, (6) oxidative stress, and (7) cellular proteolysis [6][7][8][9][10][11]17,19,21,22].…”

Section: ) Secondary Sarcopenia In Fontan Circulationmentioning

confidence: 89%

“…This phenomenon occurs not only in elderly people but also in patients with chronic illnesses such as, chronic heart failure (HF), liver dysfunction, and kidney dysfunction [1-5], which is called secondary sarcopenia. Possible explanations for sarcopenia include an abnormal energy metabolism coupled with mitochondrial dysfunction as well as a change in the structure of the myofibers, malnutrition, systemic inflammation, and oxidative stress [6][7][8][9].Recent studies have reported that secondary sarcopenia is not rare in adults with congenital heart disease (CHD) [10,11]. Sarcopenia is one of the important predictors of HF in non-CHD [12][13][14]; whereas, it remains unclear whether sarcopenia is also relevant to prognosis in adults with CHD.…”

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confidence: 99%

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Secondary sarcopenia assessed by computed tomography can predict hospitalization for heart failure in adults with Fontan circulation

Shiina

Nagao

Shimomiya

et al. 2021

Journal of Cardiology

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Sarcopenia is a loss of muscle mass and function [1]. This phenomenon occurs not only in elderly people but also in patients with chronic illnesses such as, chronic heart failure (HF), liver dysfunction, and kidney dysfunction [1-5], which is called secondary sarcopenia. Possible explanations for sarcopenia include an abnormal energy metabolism coupled with mitochondrial dysfunction as well as a change in the structure of the myofibers, malnutrition, systemic inflammation, and oxidative stress [6][7][8][9].Recent studies have reported that secondary sarcopenia is not rare in adults with congenital heart disease (CHD) [10,11]. Sarcopenia is one of the important predictors of HF in non-CHD [12][13][14]; whereas, it remains unclear whether sarcopenia is also relevant to prognosis in adults with CHD. In particular, skeletal muscle function is important in Fontan circulation because a passive blood flow in a Fontan route can be maintained by both skeletal muscle pumping and the change of intrapleural pressure (ventilatory pumping) [15][16][17]. However, it is challenging to measure the entire skeletal muscle mass; until now, dual energy X-ray absorptiometry or bioelectrical impedance analysis (BIA) has been used to measure it [1,2]. The former method needs special equipment, and the latter is not available to patients after pacemaker implantation. The biggest issue in adults with Fontan circulation is that most patients have already undergone pacemaker implantation; therefore,

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“…Specialized ACHD centers are expected to play a key role in addressing the increasing number of ACHD patients [4][5][6][7][8]. In fact, the establishment of specialized ACHD centers was shown to contribute to a significant reduction in mortality in patients with ACHD [9,10].…”

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Characteristics of patients with adult congenital heart disease treated by non-specialized doctors: The potential loss of follow-up

Nitta

Ochiai

Nakano

et al. 2021

Journal of Cardiology

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Background: In the treatment of adult congenital heart disease (ACHD), the transfer of patients from pediatric cardiologists to ACHD cardiologists is of relevance. However, little is known about the clinical courses of ACHD patients that have been referred by non-CHD-specialized doctors (n-CSDs). Methods: This retrospective cohort study included 230 patients (average age: 37 AE 15.2 years, male: 97) who were referred to a single specialized ACHD center between April 2016 and July 2019. We compared the characteristics and clinical courses between patients referred by n-CSDs and those referred by CHDspecialized-doctors (CSDs). Results: Overall, 121 (53%) patients were referred by n-CSDs. Among them, 91 (75%) patients were referred by adult cardiologists. Univariate analysis showed that the patients referred by n-CSDs were older than those referred by CSDs (41.6 AE 16.3 vs. 32.0 AE 12.0 years, p < 0.01), were more likely to have simple CHD, and less likely to have severe CHD (27.0% vs. 12.8% and 16.5% vs. 40.4%, respectively, p < 0.01). Patients referred by n-CSDs were also more likely to have a history of loss of follow-up (16.5% vs. 3.7%, p < 0.01) and to require invasive treatments after referral, including cardiac surgeries and transcatheter interventions (47.9% vs. 26.6 %, p < 0.01). Notably, unintended invasive treatments that were not designated by the referring doctors were more frequently required in patients with moderate complexity referred by n-CSDs (50.0% vs. 23.3%, p = 0.02). Conclusions: Patients with moderate CHD complexity referred by n-CSDs are more likely to require unintended invasive treatments. Referrals to specialized ACHD centers may be most beneficial for these patients.

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Sarcopenia in adults with congenital heart disease: Nutritional status, dietary intake, and resistance training

Cited by 18 publications

References 25 publications

Metabolic Syndrome in Adult Congenital Heart Disease

Metabolic Syndrome in Adult Congenital Heart Disease

Secondary sarcopenia assessed by computed tomography can predict hospitalization for heart failure in adults with Fontan circulation

Characteristics of patients with adult congenital heart disease treated by non-specialized doctors: The potential loss of follow-up

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