Sarcopenia in heart failure: ‘waste’ the appropriate time and resources, not the muscles

Kokkinidis, Damianos G.; Arfaras-Melainis, Angelos; Giannakoulas, George

doi:10.1093/eurjpc/zwaa139

Cited by 3 publications

(1 citation statement)

References 25 publications

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“…Importantly, both hypoalbuminemia and sarcopenia are associated with chronic diseases and advanced age, as well as each other. 40 , 41 Such co‐occurrence has been described previously as malnutrition–sarcopenia syndrome, in which both malnutrition and loss of skeletal muscle mass manifest in a cycle of physical frailty that causes continuous functional deterioration of patients and, thus, poorer outcomes. 42 However, it is important to note that although hypoalbuminemia has been traditionally viewed as a surrogate clinical marker for malnutrition, there is scant evidence to support this relationship.…”

Section: Discussionmentioning

confidence: 99%

Combined Prognostic Impact of Low Muscle Mass and Hypoalbuminemia in Patients Hospitalized for Heart Failure: A Retrospective Cohort Study

Mirzai,

Sarnaik,

Persits

et al. 2024

JAHA

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Background Sarcopenia and hypoalbuminemia have been identified as independent predictors of increased adverse outcomes, including mortality and readmissions, in hospitalized older adults with acute decompensated heart failure (ADHF). However, the impact of coexisting sarcopenia and hypoalbuminemia on morbidity and death in adults with ADHF has not yet been investigated. We aimed to investigate the combined effects of lower muscle mass (LMM) as a surrogate for sarcopenia and hypoalbuminemia on in‐hospital and postdischarge outcomes of patients hospitalized for ADHF. Methods and Results A total of 385 patients admitted for ADHF between 2017 and 2020 at a single institution were retrospectively identified. Demographic and clinical data were collected, including serum albumin levels at admission and discharge. Skeletal muscle indices were derived from semi‐automated segmentation software analysis on axial chest computed tomography at the twelfth vertebral level. Our analysis revealed that patients who had LMM with admission hypoalbuminemia experienced increased diagnoses of infection and delirium with longer hospital length of stay and more frequent discharge to a facility. Upon discharge, 27.9% of patients had higher muscle mass without discharge hypoalbuminemia (reference group), 9.7% had LMM without discharge hypoalbuminemia, 38.4% had higher muscle mass with discharge hypoalbuminemia, and 24.0% had LMM with discharge hypoalbuminemia; mortality rates were 37.6%, 51.4%, 48.9%, and 63.2%, respectively. 1‐ and 3‐year mortality risks were highest in those with LMM and discharge hypoalbuminemia; this relationship remained significant over a median 23.6 (3.1–33.8) months follow‐up time despite multivariable adjustments (hazard ratio, 2.03 [95% CI, 1.31–3.16]; P =0.002). Conclusions Hospitalization with ADHF, LMM, and hypoalbuminemia portend heightened mortality risk.

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Section: Discussionmentioning

confidence: 99%

Combined Prognostic Impact of Low Muscle Mass and Hypoalbuminemia in Patients Hospitalized for Heart Failure: A Retrospective Cohort Study

Mirzai,

Sarnaik,

Persits

et al. 2024

JAHA

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A Meta-Analysis on the Impact of High BMI in Patients Undergoing Transcatheter Aortic Valve Replacement

Seo

Safiriyu

et al. 2022

JCDD

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Background: A paradoxical association of obesity with lower risk of transcatheter aortic valve replacement (TAVR) outcomes has been reported. We aimed to systematically review the literature and compare TAVR-related morbidity and mortality among individuals with overweight or obesity and their peers with normal body mass index (BMI). Methods: PubMed and Embase databases were systematically searched for studies reporting TAVR outcomes in different BMI groups. Separate meta-analyses were conducted for studies reporting hazard ratios (HR) and odds ratios/relative risks. Short- and mid-/long-term outcomes were examined. Results: 26 studies with a total of 74,163 patients were included in our study. Overweight was associated with lower risk of short-term mortality (HR: 0.77; 95% CI: 0.60–0.98) and mid-/long-term mortality (HR: 0.79; 95% CI: 0.70–0.89). Obesity was associated with lower risk for mid-/long-term mortality (HR: 0.79; 95% CI: 0.73–0.86), but no difference was observed in short-term mortality, although a trend was noted (HR: 0.87l 95% CI: 0.74–1.01). Individuals with obesity demonstrated an association with higher odds of major vascular complications (OR: 1.33; 95% CI: 1.05–1.68). Both overweight (OR: 1.16; 95% CI: 1.03–1.30) and obesity (OR: 1.26; 95% CI: 1.06–1.50) were associated with higher likelihood for receiving permanent pacemakers after TAVR. Conclusion: Individuals with overweight and obesity were associated with lower mortality risk compared to those with normal BMI but with higher likelihood of major vascular complications and permanent pacemaker implantation after TAVR.

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RETRACTED: Cardiovascular Disease and Exercise: From Molecular Mechanisms to Clinical Applications

Wang

Gan

Deng

et al. 2022

JCM

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Inactivity is a significant risk factor for cardiovascular disease. Exercise may greatly enhance the metabolism and function of the cardiovascular system, lower several risk factors, and prevent the development and treatment of cardiovascular disease while delivering easy, physical, and emotional enjoyment. Exercise regulates the cardiovascular system by reducing oxidative stress and chronic inflammation, regulating cardiovascular insulin sensitivity and the body’s metabolism, promoting stem cell mobilization, strengthening autophagy and myocardial mitochondrial function, and enhancing cardiovascular damage resistance, among other effects. Appropriate exercise intervention has become an essential adjuvant therapy in clinical practice for treating and rehabilitating various cardiovascular diseases. However, the prescription of exercise for preventing and treating cardiovascular diseases, particularly the precise selection of individual exercise techniques and their volume, remains controversial. Using multiomics to explain further the molecular process underlying the positive effects of exercise on cardiovascular health will not only improve our understanding of the effects of exercise on health but also establish a scientific basis and supply new ideas for preventing and treating cardiovascular diseases by activating the endogenous protective mechanisms of the body and suggesting more specific exercise prescriptions for cardiovascular rehabilitation.

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Sarcopenia in heart failure: ‘waste’ the appropriate time and resources, not the muscles

Cited by 3 publications

References 25 publications

Combined Prognostic Impact of Low Muscle Mass and Hypoalbuminemia in Patients Hospitalized for Heart Failure: A Retrospective Cohort Study

Combined Prognostic Impact of Low Muscle Mass and Hypoalbuminemia in Patients Hospitalized for Heart Failure: A Retrospective Cohort Study

A Meta-Analysis on the Impact of High BMI in Patients Undergoing Transcatheter Aortic Valve Replacement

RETRACTED: Cardiovascular Disease and Exercise: From Molecular Mechanisms to Clinical Applications

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