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Hong Y, Gao Z, Wei H, Wei Y, Qiu Z, Xiao J, Huang W. Bi-directional association of body size and composition with heart failure: A Mendelian randomization study. Int J Cardiol 2024; 407:132069. [PMID: 38642721 DOI: 10.1016/j.ijcard.2024.132069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 03/25/2024] [Accepted: 04/17/2024] [Indexed: 04/22/2024]
Abstract
PURPOSE The effect of obesity on the development of heart failure (HF) has received attention, and this study intends to further explore the bidirectional association between body size or composition and HF by using Mendelian Randomization (MR) approach. DESIGN We performed a two-sample bidirectional MR study to investigate the association between body size or composition and the risk of HF using aggregated data from genome-wide association studies. Univariable MR analysis was used to investigate the causal relationship, and multivariable MR analysis was used to explore the mediating role of general and central obesity in the relationship between body size or composition and HF. RESULTS This forward MR study found that body mass index (BMI), waist circumference (WC), waist-hip ratio (WHR), fat mass (FM) and fat-free mass (FFM) were risk factors for the development of HF with the strength of causal association BMI > FM > WC > FFM > WHR. After adjusting for BMI, the observed associations between the remaining indicators and heart failure attenuated to null. After adjusting for WC, only BMI (OR = 1.59, 95%CI: 1.32-1.92, P = 9.53E-07) and FM (OR = 1.39, 95%CI: 1.20-1.62, P = 1.35E-0.5) kept significantly related to the risk of HF. Reverse MR analysis showed no association of changes in body size or composition with the onset of HF. CONCLUSION The two-sample bidirectional MR study found that general obesity, measured by BMI, was an independent indicator of the development of HF, while other related indicators were associated with HF incidence dependent on BMI, besides, no association was observed between HF diagnosis and the body size or composites.
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Affiliation(s)
- Yuqi Hong
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, Fujian, China; Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Ziting Gao
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, Fujian, China
| | - Hongye Wei
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, Fujian, China
| | - Yajing Wei
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, Fujian, China
| | - Ziyi Qiu
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, Fujian, China
| | - Jun Xiao
- Department of Cardiovascular Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian, China; Fujian Provincial Clinical Research Center for Cardiovascular Diseases Heart Center of Fujian Medical University, Fuzhou, Fujian, China.
| | - Wuqing Huang
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, Fujian, China.
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Tinggaard AB, Skou MK, Jessen N, Nørrelund H, Wiggers H. ALM/BMI: A Clinically Superior Index for Identifying Skeletal Muscle Dysfunction in Patients With Heart Failure. J Am Heart Assoc 2024; 13:e033571. [PMID: 38686857 PMCID: PMC11179929 DOI: 10.1161/jaha.123.033571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 03/12/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND Skeletal muscle wasting is critical in patients with heart failure (HF). Whereas prior studies have employed appendicular lean mass (ALM) normalized by height squared to identify low skeletal muscle mass, the potential of ALM normalized to body mass index (ALM/BMI) remains unexplored in patients with HF. In this study, we compared the use of 2 skeletal muscle mass indices in patients with HF to examine their sex-specific correlations with measures of physical capacity, quality of life, and daily physical activity. METHODS AND RESULTS A total of 111 patients with HF underwent dual x-ray absorptiometry, physical capacity tests, and accelerometry and answered a quality-of-life questionnaire. ALM normalized by height squared and ALM/BMI indices disagreed in classifying low muscle mass (Cohen's κ, -0.008 [95% CI, -0.094 to 0.177]; P=0.93). ALM/BMI correlated well with 6-minute walking distance in women and men (R=0.67 and 0.49; P<0.001), with maximal oxygen uptake in women and men (R=0.41 and 0.48; P<0.05), and with maximal muscle strength in women and men (R=0.54 and 0.43; P<0.01). Inversely, ALM normalized by height squared did not correlate significantly with 6-minute walking distance or maximal oxygen uptake and correlated with maximal muscle strength only in men (R=0.43; P<0.001). Only ALM/BMI allowed for identification of a low-muscle-mass group characterized by poor quality of life (Minnesota Living With Heart Failure Questionnaire score of 33±21 versus 25±16; P=0.027) and less daily time spent in moderate to vigorous physical activity (8 [3-17] versus 15 [9-37] minutes; P<0.001). CONCLUSIONS ALM/BMI was superior for identifying clinically significant muscle dysfunction in both female and male patients with HF.
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Affiliation(s)
- Andreas Bugge Tinggaard
- Department of Cardiology Aarhus University Hospital Aarhus Denmark
- Department of Clinical Medicine Aarhus University Aarhus Denmark
| | - Maria Kreiberg Skou
- Department of Physiotherapy and Occupational Therapy Aarhus University Hospital Aarhus Denmark
| | - Niels Jessen
- Steno Diabetes Center Aarhus Aarhus University Hospital Aarhus Denmark
- Department of Biomedicine Aarhus University Aarhus Denmark
- Department of Clinical Pharmacology Aarhus University Hospital Aarhus Denmark
| | - Helene Nørrelund
- Department of Clinical Medicine Aarhus University Aarhus Denmark
| | - Henrik Wiggers
- Department of Cardiology Aarhus University Hospital Aarhus Denmark
- Department of Clinical Medicine Aarhus University Aarhus Denmark
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Katano S, Yano T, Yamano K, Numazawa R, Nagaoka R, Honma S, Fujisawa Y, Ohori K, Kouzu H, Kunihara H, Fujisaki H, Katayose M, Hashimoto A, Furuhashi M. Associations between in-hospital daily protein intake and adverse clinical outcomes in older patients with heart failure. ESC Heart Fail 2024. [PMID: 38705583 DOI: 10.1002/ehf2.14812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 02/28/2024] [Accepted: 04/01/2024] [Indexed: 05/07/2024] Open
Abstract
AIMS The adverse effects of low daily protein intake (DPI) on clinical outcomes in patients with heart failure (HF) are known; however, an optimal DPI to predict event adverse outcomes remains undetermined. Moreover, whether protein restriction therapy for chronic kidney disease is applicable in patients with HF and renal dysfunction remains unclear. METHODS AND RESULTS In this single-centre, ambispective cohort study, we included 405 patients with HF aged ≥65 years (mean age, 78.6 ± 7.5 years; 50% women). DPI was estimated from consumption over three consecutive days before discharge and normalized relative to the ideal body weight [IBW, 22 kg/m2 × height (m)2]. The primary outcome was a composite of all-cause mortality and HF-related readmission within the 2 year post-discharge period. RESULTS During an average follow-up period of 1.49 ± 0.74 years, 100 patients experienced composite events. Kaplan-Meier survival curves revealed a significantly lower composite event-free rate in patients within the lowest quartile of DPI than in the upper quartiles (log-rank test, P = 0.02). A multivariate Cox proportional hazards analysis after adjusting for established prognostic markers and non-proteogenic energy intake revealed that patients in the lowest DPI quartile faced a two-fold higher risk of composite events than those in the highest quartile [hazard ratio (HR), 2.03; 95% confidence interval (CI), 1.08-3.82; P = 0.03]. The composite event risk linearly increased as DPI decreased (P for nonlinearity = 0.90), with each standard deviation (0.26 g/kg IBW/day) decrease in DPI associated with a 32% increase in composite event risk (HR, 1.32; 95% CI, 1.10-1.71; P = 0.04). There was significant heterogeneity in the effect of DPI, with the possible disadvantage of lower DPI in patients with HF with cystatin C-based estimated glomerular filtration rate <30 mL/min/1.73 m2. The cutoff value of DPI for predicting the occurrence of composite events calculated from the Youden index was 1.12 g/kg IBW/day. Incorporating a DPI < 1.12 g/kg IBW/day into the baseline model significantly improved the prediction of post-discharge composite events (continuous net reclassification improvement, 0.294; 95% CI, 0.072-0.516; P = 0.01). CONCLUSIONS Lower DPI during hospitalization is associated with an increased risk of mortality and HF readmission independent of non-proteogenic energy intake, and the possible optimal DPI for predicting adverse clinical outcomes is >1.12 g/kg IBW/day in older patients with HF. Caution is warranted when protein restriction therapy is administered to older patients with HF and renal dysfunction.
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Affiliation(s)
- Satoshi Katano
- Division of Rehabilitation, Sapporo Medical University Hospital, Sapporo, Hokkaido, Japan
- Second Division of Physical Therapy, Sapporo Medical University School of Health Sciences, Sapporo, Hokkaido, Japan
| | - Toshiyuki Yano
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
| | - Kotaro Yamano
- Division of Rehabilitation, Sapporo Medical University Hospital, Sapporo, Hokkaido, Japan
- Second Division of Physical Therapy, Sapporo Medical University School of Health Sciences, Sapporo, Hokkaido, Japan
| | - Ryo Numazawa
- Graduate School of Medicine, Sapporo Medical University, Sapporo, Hokkaido, Japan
| | - Ryohei Nagaoka
- Division of Rehabilitation, Sapporo Medical University Hospital, Sapporo, Hokkaido, Japan
- Graduate School of Medicine, Sapporo Medical University, Sapporo, Hokkaido, Japan
| | - Suguru Honma
- Graduate School of Medicine, Sapporo Medical University, Sapporo, Hokkaido, Japan
- Department of Rehabilitation, Sapporo Cardiovascular Hospital, Sapporo, Hokkaido, Japan
| | - Yusuke Fujisawa
- Second Division of Physical Therapy, Sapporo Medical University School of Health Sciences, Sapporo, Hokkaido, Japan
- Department of Rehabilitation, Japanese Red Cross Asahikawa Hospital, Asahikawa, Hokkaido, Japan
| | - Katsuhiko Ohori
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
- Department of Cardiology, Hokkaido Cardiovascular Hospital, Sapporo, Hokkaido, Japan
| | - Hidemichi Kouzu
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
| | - Hayato Kunihara
- Division of Rehabilitation, Sapporo Medical University Hospital, Sapporo, Hokkaido, Japan
| | - Hiroya Fujisaki
- Division of Rehabilitation, Sapporo Medical University Hospital, Sapporo, Hokkaido, Japan
| | - Masaki Katayose
- Second Division of Physical Therapy, Sapporo Medical University School of Health Sciences, Sapporo, Hokkaido, Japan
| | - Akiyoshi Hashimoto
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
- Division of Health Care Administration and Management, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
| | - Masato Furuhashi
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
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Saito H, Matsue Y, Maeda D, Kagiyama N, Endo Y, Yoshioka K, Mizukami A, Minamino T. Sarcopenia prognosis using dual-energy X-ray absorptiometry and prediction model in older patients with heart failure. ESC Heart Fail 2024; 11:914-922. [PMID: 38212896 DOI: 10.1002/ehf2.14667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 11/30/2023] [Accepted: 12/18/2023] [Indexed: 01/13/2024] Open
Abstract
AIMS This study aimed to determine whether there is a difference in the prognostic value of sarcopenia diagnosed using dual-energy X-ray absorptiometry (DEXA) and that predicted by prediction equations in older patients with heart failure (HF). METHODS AND RESULTS We included 269 patients (aged ≥65 years) who were hospitalized for HF. We used two appendicular skeletal muscle mass (ASM) prediction equations: (i) Anthropometric-ASM, including age, sex, height, and weight, and (ii) Predicted-ASM, including sex, weight, calf circumference, and mid-arm circumference. ASM index (ASMI) was calculated by dividing the sum of the ASM in the extremities by the height squared (kg/m2). The cut-off values proposed by the Asian Working Group for Sarcopenia 2019 were used to define low ASMI. The prognostic endpoint was all-cause mortality. The median age of the cohort was 83 years [interquartile range (IQR): 75-87], and 135 patients (50.2%) were men. Sarcopenia diagnosed according to DEXA, Anthropometric measurements, and Predicted-ASM was observed in 134 (49.8%), 171 (63.6%), and 157 (58.4%) patients, respectively. During the median follow-up period of 690 days (IQR: 459-730), 54 patients (19.9%) died. DEXA-sarcopenia [hazard ratio (HR), 2.33; 95% confidence interval (CI), 1.26-4.31; P = 0.007] was associated with all-cause mortality after adjusting for pre-existing risk factors, whereas Predicted-sarcopenia (HR, 1.68; 95% CI, 0.87-3.25; P = 0.123) and Anthropometric-sarcopenia (HR, 1.64; 95% CI, 0.86-3.12; P = 0.132) were not. CONCLUSIONS Sarcopenia diagnosed using DEXA was associated with poor prognosis in older patients with HF; however, the prediction equations were not.
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Affiliation(s)
- Hiroshi Saito
- Department of Rehabilitation, Kameda Medical Center, Kamogawa, Chiba, Japan
| | - Yuya Matsue
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Daichi Maeda
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Nobuyuki Kagiyama
- Department of Digital Health and Telemedicine R&D, Juntendo University, Tokyo, Japan
| | - Yoshiko Endo
- Department of Rehabilitation, Kameda Medical Center, Kamogawa, Chiba, Japan
| | - Kenji Yoshioka
- Department of Cardiology, Kameda Medical Center, Kamogawa, Chiba, Japan
| | - Akira Mizukami
- Department of Cardiology, Kameda Medical Center, Kamogawa, Chiba, Japan
| | - Tohru Minamino
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
- Japan Agency for Medical Research and Development-Core Research for Evolutionary Medical Science and Technology (AMED-CREST), Japan Agency for Medical Research and Development, Tokyo, Japan
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Nagaoka R, Katano S, Yano T, Numazawa R, Yamano K, Fujisawa Y, Honma S, Kamoda T, Sato K, Kouzu H, Ohori K, Katayose M, Hashimoto A, Furuhashi M. Optimal serum 25-hydroxyvitamin D level to prevent sarcopenia in patients with heart failure: Insights from a dose-response relationship. Nutr Metab Cardiovasc Dis 2024; 34:606-617. [PMID: 38000999 DOI: 10.1016/j.numecd.2023.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 08/09/2023] [Accepted: 10/04/2023] [Indexed: 11/26/2023]
Abstract
BACKGROUND AND AIMS Low serum 25-hydroxyvitamin D (25 [OH]D) levels have been associated with sarcopenia, frailty, and risk of cardiovascular disease, whereas high levels negatively impact clinical outcomes. We determined optimal serum 25(OH)D concentrations to minimise the probability of sarcopenia in patients with heart failure (HF) by examining the dose-dependent relationship between serum 25(OH)D levels and sarcopenia. METHODS AND RESULTS We enrolled 461 consecutive patients with HF (mean age, 72 ± 15 years; 39% female) who underwent dual-energy X-ray absorptiometry. Serum 25(OH)D levels were measured using a chemiluminescence immunoassay. Sarcopenia was diagnosed according to the 2019 Asian Working Group for Sarcopenia criteria. Overall, 49% of enrolled patients were diagnosed with sarcopenia. Adjusted logistic regression with restricted cubic spline function revealed that the odds ratio (OR) of sarcopenia increased in patients with HF presenting serum 25(OH)D levels <14.6 ng/ml or > 31.4 ng/ml, reaching the lowest OR at ∼20 ng/ml. Multivariate logistic regression revealed that a serum 25(OH)D level below 14.6 ng/mL was independently associated with the presence of sarcopenia (adjusted OR: 2.16, 95% confidence interval [CI]: 1.24-3.78). Incorporating serum 25(OH)D levels <14.6 ng/ml, but not <20.0 ng/ml, in the baseline model improved continuous net reclassification (0.334, 95% CI: 0.122-0.546) in patients with HF. CONCLUSION A U-shaped relationship exists between serum 25(OH)D levels and sarcopenia probability in patients with HF. Maintaining serum 25(OH)D levels between 14.6 and 31.4 ng/ml may help prevent sarcopenia in patients with HF.
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Affiliation(s)
- Ryohei Nagaoka
- Division of Rehabilitation, Sapporo Medical University Hospital, Sapporo, Japan
| | - Satoshi Katano
- Division of Rehabilitation, Sapporo Medical University Hospital, Sapporo, Japan; Second Division of Physical Therapy, Sapporo Medical University School of Health Science, Sapporo, Japan.
| | - Toshiyuki Yano
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Ryo Numazawa
- Graduate School of Medicine, Sapporo Medical University, Sapporo, Japan
| | - Kotaro Yamano
- Division of Rehabilitation, Sapporo Medical University Hospital, Sapporo, Japan
| | - Yusuke Fujisawa
- Division of Rehabilitation, Sapporo Medical University Hospital, Sapporo, Japan
| | - Suguru Honma
- Second Division of Physical Therapy, Sapporo Medical University School of Health Science, Sapporo, Japan; Department of Rehabilitation, Sapporo Cardiovascular Hospital, Sapporo, Japan
| | - Tatsuki Kamoda
- Graduate School of Health Sciences, Sapporo Medical University, Sapporo, Japan
| | - Kohei Sato
- Graduate School of Health Sciences, Sapporo Medical University, Sapporo, Japan
| | - Hidemichi Kouzu
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Katsuhiko Ohori
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan; Department of Cardiology, Hokkaido Cardiovascular Hospital, Sapporo, Japan
| | - Masaki Katayose
- Second Division of Physical Therapy, Sapporo Medical University School of Health Science, Sapporo, Japan
| | - Akiyoshi Hashimoto
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan; Division of Health Care Administration and Management, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Masato Furuhashi
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
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Clarkson S, Payne GA. Quality over quantity - Assessing the influence of body muscle composition on cardiovascular health. Am J Med Sci 2024; 367:151-152. [PMID: 38135274 DOI: 10.1016/j.amjms.2023.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 12/18/2023] [Indexed: 12/24/2023]
Affiliation(s)
- Stephen Clarkson
- Department of Medicine, University of Alabama at Birmingham (UAB); Birmingham, AL, USA; Division of Cardiovascular Diseases, UAB Department of Medicine; Birmingham, AL, USA; UAB Comprehensive Cardiovascular Center; Birmingham, AL, USA; Birmingham VA Health Care Center; Birmingham, AL, USA
| | - Gregory A Payne
- Department of Medicine, University of Alabama at Birmingham (UAB); Birmingham, AL, USA; Division of Cardiovascular Diseases, UAB Department of Medicine; Birmingham, AL, USA; UAB Comprehensive Cardiovascular Center; Birmingham, AL, USA; Birmingham VA Health Care Center; Birmingham, AL, USA; UAB Cardiopulmonary Research Program; Birmingham, AL, USA.
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Yang C, Zhang L, Cheng Y, Zhang M, Zhao Y, Zhang T, Dong J, Xing J, Zhen Y, Wang C. High intensity interval training vs. moderate intensity continuous training on aerobic capacity and functional capacity in patients with heart failure: a systematic review and meta-analysis. Front Cardiovasc Med 2024; 11:1302109. [PMID: 38450369 PMCID: PMC10915068 DOI: 10.3389/fcvm.2024.1302109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 02/07/2024] [Indexed: 03/08/2024] Open
Abstract
Background Exercise training is commonly employed as a efficacious supplementary treatment for individuals suffering from heart failure, but the optimal exercise regimen is still controversial. The objective of the review was to compare the effects of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on the exercise capacity, cardiac function, quality of life (QoL) and heart rate among patients with heart failure with reduced ejection fraction. Methods A systematic search was performed using the following eight databases from their inception to July 5, 2023: PubMed, Web of Science, Embase, Cochrane Library, Clinical Trials, China Knowledge Network, Wan fang Data, and the China Biology Medicine databases. The meta-analysis results were presented as mean difference (MD) and 95% confidence interval (CI). The Cochrane Risk of Bias tool was used for the included studies. The Grading of Recommendations Assessment, Development, and Evaluations was used to assess the certainty of evidence. Results Thirteen randomized controlled trials were included in the study. The results showed that HIIT had a significant positive effect on peak oxygen uptake (MD = 1.78, 95% CI for 0.80-2.76), left ventricular ejection fraction (MD = 3.13, 95% CI for 1.25-5.02), six-minute walk test (MD = 28.13, 95% CI for 14.56-41.70), and Minnesota Living with Heart Failure Questionnaire (MD = -4.45, 95% CI for -6.25 to -2.64) compared to MICT. However, there were no statistically significant differences observed in resting heart rate and peak heart rate. Conclusions HIIT significantly improves peak oxygen uptake, left ventricular ejection fraction, six-minute walk test, and Minnesota Living with Heart Failure Questionnaire in patients with heart failure with reduced ejection fraction. Additionally, HIIT exhibits greater effectiveness in improving peak oxygen uptake among patients with lower body mass index. Systematic Review Registration https://www.doi.org/10.37766/inplasy2023.7.0100, identifier (INPLASY2023.7.0100).
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Affiliation(s)
- Changran Yang
- Department of Rehabilitation, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Lizhuang Zhang
- Department of Rehabilitation, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Yu Cheng
- Department of Rehabilitation, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Manman Zhang
- Department of Rehabilitation, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Yuxin Zhao
- Department of Rehabilitation, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Tianzi Zhang
- Department of Rehabilitation, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Jiawang Dong
- Department of Rehabilitation, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Jun Xing
- Department of Rehabilitation, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Yuzhi Zhen
- Department of Cardiology, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Cuihua Wang
- Department of Rehabilitation, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
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Ohori K, Yano T, Katano S, Nagaoka R, Numazawa R, Yamano K, Fujisawa Y, Kouzu H, Nagano N, Fujito T, Nishikawa R, Ohwada W, Furuhashi M. Coexistence of sarcopenia and self-reported weight loss is a powerful predictor of mortality in older patients with heart failure. Geriatr Gerontol Int 2024; 24:95-101. [PMID: 38088489 DOI: 10.1111/ggi.14778] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 11/08/2023] [Accepted: 11/28/2023] [Indexed: 01/05/2024]
Abstract
AIM We examined whether the addition of self-reported weight loss improves the accuracy of prediction of mortality caused by sarcopenia in heart failure (HF) patients. METHODS We enrolled 477 HF patients (mean age 77 years) who received combined assessment of sarcopenia and self-reported weight loss. Sarcopenia was diagnosed according to the criteria of the Asian Working Group for Sarcopenia. If the patients answered "yes" to the question "have you lost 2 kg or more in the past 6 months?", they were diagnosed as having self-reported weight loss. RESULTS Sarcopenia and self-reported weight loss coexisted in 32% of patients. During a median follow-up period of 763 days, 65 patients (15%) died. Kaplan-Meier curves showed a significantly higher rate of mortality in HF patients with both sarcopenia and self-reported weight loss than in HF patients with sarcopenia alone. Multivariate Cox proportional hazards analysis showed that the coexistence of sarcopenia and self-reported weight loss is an independent predictor of mortality in HF patients. Inclusion of the coexistence of sarcopenia and self-reported weight loss in the baseline model consisting of established prognostic markers significantly improved both the net reclassification index and the integrated discrimination index. CONCLUSIONS The coexistence of sarcopenia and self-reported weight loss is a powerful predictor of mortality in HF patients. Geriatr Gerontol Int 2024; 24: 95-101.
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Affiliation(s)
- Katsuhiko Ohori
- Department of Cardiology, Hokkaido Cardiovascular Hospital, Sapporo, Japan
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Toshiyuki Yano
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Satoshi Katano
- Division of Rehabilitation, Sapporo Medical University Hospital, Sapporo, Japan
| | - Ryohei Nagaoka
- Division of Rehabilitation, Sapporo Medical University Hospital, Sapporo, Japan
| | - Ryo Numazawa
- Graduate School of Medicine, Sapporo Medical University, Sapporo, Japan
| | - Kotaro Yamano
- Division of Rehabilitation, Sapporo Medical University Hospital, Sapporo, Japan
| | - Yusuke Fujisawa
- Department of Rehabilitation, Japanese Red Cross Asahikawa Hospital, Asahikawa, Japan
| | - Hidemichi Kouzu
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Nobutaka Nagano
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Takefumi Fujito
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Ryo Nishikawa
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Wataru Ohwada
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Masato Furuhashi
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
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Katano S, Yano T, Kouzu H, Nagaoka R, Numazawa R, Yamano K, Fujisawa Y, Ohori K, Nagano N, Fujito T, Nishikawa R, Ohwada W, Katayose M, Sato T, Kuno A, Furuhashi M. Circulating level of β-aminoisobutyric acid (BAIBA), a novel myokine-like molecule, is inversely associated with fat mass in patients with heart failure. Heart Vessels 2024; 39:35-47. [PMID: 37661199 DOI: 10.1007/s00380-023-02308-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 08/16/2023] [Indexed: 09/05/2023]
Abstract
Results of experimental studies have shown that β-aminoisobutyric acid (BAIBA), an exercise-induced myokine-like molecule, is an endogenous negative regulator of fat mass in mice, but it remains unclear whether that is the case in humans, though an enhanced BAIBA concentration in patients receiving sodium-glucose cotransporter 2 inhibitors was found in our recent study. The objective of this study was to analyze the determinants of circulating BAIBA concentration in humans, with focus on the possible link between circulating BAIBA and body composition including fat mass. Data for 188 consecutive patients with heart failure (HF, 64 ± 13 years; 70% male) who received a dual energy X ray absorptiometry (DEXA) scan for assessment of body composition including fat mass index (FMI) and appendicular skeletal muscle mass index (ASMI) were used in this study. Plasma BAIBA concentration in a fasting state after stabilization of HF was determined using ultraperformance liquid chromatography. Plasma BAIBA was detected in 66% of the patients. In simple linear regression analyses of data from patients in whom plasma BAIBA was detected, plasma BAIBA concentration was positively correlated with uric acid and was negatively correlated with body mass index (BMI), estimated glomerular filtration rate (eGFR), FMI, and % body fat. There were no correlations between plasma BAIBA concentration and indexes of muscle mass and bone mass. The results of multiple linear regression analyses showed that FMI and % body fat in addition to BMI, but not ASMI, were independent explanatory factors for plasma BAIBA concentration. In conclusion, plasma BAIBA concentration is inversely correlated with indexes of fat mass, indicating that BAIBA may be a therapeutic target for excessive fat accumulation.
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Affiliation(s)
- Satoshi Katano
- Division of Rehabilitation, Sapporo Medical University Hospital, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan
| | - Toshiyuki Yano
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan.
| | - Hidemichi Kouzu
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan
| | - Ryohei Nagaoka
- Division of Rehabilitation, Sapporo Medical University Hospital, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan
| | - Ryo Numazawa
- Division of Rehabilitation, Sapporo Medical University Hospital, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan
- Graduate School of Medicine, Sapporo Medical University, South-1, West-17, Chuo-ku, Sapporo, 060-8556, Japan
| | - Kotaro Yamano
- Division of Rehabilitation, Sapporo Medical University Hospital, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan
| | - Yusuke Fujisawa
- Department of Rehabilitation, Japanese Red Cross Asahikawa Hospital, 1-1-1-1, Akebono, Asahikawa, 070-8530, Japan
| | - Katsuhiko Ohori
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan
- Department of Cardiology, Hokkaido Cardiovascular Hospital, 1-30, South-27, West-13, Chuo-ku, Sapporo, 064-0927, Japan
| | - Nobutaka Nagano
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan
| | - Takefumi Fujito
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan
| | - Ryo Nishikawa
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan
| | - Wataru Ohwada
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan
| | - Masaki Katayose
- Second Division of Physical Therapy, Sapporo Medical University School of Health Sciences, South-1, West-17, Chuo-ku, Sapporo, 060-8556, Japan
| | - Tatsuya Sato
- Department of Cellular Physiology and Signal Transduction, Sapporo Medical University School of Medicine, South-1, West-17, Chuo-ku, Sapporo, 060-8556, Japan
| | - Atsushi Kuno
- Department of Pharmacology, Sapporo Medical University School of Medicine, South-1, West-17, Chuo-ku, Sapporo, 060-8556, Japan
| | - Masato Furuhashi
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan
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10
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Payal F, Bansari RB, Saveeta F. Comment on "Exploring the Factors Associated With Decreased Dynamic Balance Ability in Older Patients With Heart Failure". Curr Probl Cardiol 2023; 48:101968. [PMID: 37473941 DOI: 10.1016/j.cpcardiol.2023.101968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 07/16/2023] [Indexed: 07/22/2023]
Affiliation(s)
- Fnu Payal
- Ghulam Muhammad Mahar Medical College, Sukkur, Pakistan
| | - Raveena Bai Bansari
- Peoples University of Medical and Health Sciences for Women, Nawabshah, Pakistan
| | - Fnu Saveeta
- Peoples University of Medical and Health Sciences for Women, Nawabshah, Pakistan.
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11
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Hu Y, Zhang C, Zou C, Yang H, Chen Y, Liang T. Anthropometric measures and physical examination could be used to assess phenotypic GLIM (Global leadership initiative on malnutrition) criteria in heart failure patients. Nutr Metab Cardiovasc Dis 2023; 33:2419-2427. [PMID: 37788948 DOI: 10.1016/j.numecd.2023.07.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 07/20/2023] [Accepted: 07/24/2023] [Indexed: 10/05/2023]
Abstract
BACKGROUND AND AIMS The assessment of muscle mass using technology-based methods is less commonly performed when applying the Global Leadership Initiative on Malnutrition (GLIM) criteria due to the lack of skilled clinical nutrition practitioners and/or equipment. Based on the predictive validity of poor health outcomes and feasibility in clinical practice, this study aimed to analyze whether the measurement of calf circumference (CC), mid-upper arm circumference (MAC), and the physical examination could be used as substitutes for muscle mass assessment, as well as handgrip strength (HGS) used as a substitution when applying the GLIM criteria in hospitalized HF patients. METHODS AND RESULTS From June 2022 to January 2023, a single-center prospective study including 216 patients was performed. Additionally, covariates were identified by a directed acyclic graph. The multivariate logistic regression analysis was also used to analyze and compare the association between poor health outcomes and malnutrition (based on 5 types of GLIM criteria). Cohen-kappa coefficient and TELOS-feasibility score were calculated. The prevalence of malnutrition ranged from 35.2% to 42.6%, depending on the tool used. After adjusting for covariates, malnutrition assessed using CC, MAC, or physical examination within the GLIM criteria was independently associated with poor clinical outcomes (90-day HF-related readmission or all-cause mortality and prolonged hospital stay) but not with HGS. CONCLUSION CC, MAC and results from physical examination but not HGS may serve as a substitutive metric of muscle mass contained in the GLIM criteria to diagnose malnutrition and predict poor clinical outcomes among HF patients. REGISTRATION NUMBER This study was registered at Chinese Clinical Trial Registry. (ChiCTR2200057876) on 20 Mar. 2022.
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Affiliation(s)
- Yule Hu
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China; School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, NO.9 Dong Dan San Tiao, 100730, Beijing, China
| | - Chen Zhang
- Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, 100045, Beijing, China
| | - Changhong Zou
- Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, 100045, Beijing, China
| | - Haojie Yang
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, NO.9 Dong Dan San Tiao, 100730, Beijing, China
| | - Yingdi Chen
- Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, 100045, Beijing, China
| | - Tao Liang
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, NO.9 Dong Dan San Tiao, 100730, Beijing, China.
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12
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Onishi S, Fukuda A, Matsui M, Ushiro K, Nishikawa T, Asai A, Kim SK, Nishikawa H. Association between the Suita Score and Body Composition in Japanese Adults: A Large Cross-Sectional Study. Nutrients 2023; 15:4816. [PMID: 38004210 PMCID: PMC10674627 DOI: 10.3390/nu15224816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 11/08/2023] [Accepted: 11/14/2023] [Indexed: 11/26/2023] Open
Abstract
The purpose of this study was to clarify the relationship between the Suita score (a prediction model for the development of cardiovascular disease) and body composition in Japanese health check-up subjects (6873 men and 8685 women). The Suita score includes 8 items (age, gender, smoking, diabetes, blood pressure, low-density lipoprotein, high-density lipoprotein, and chronic kidney disease). Factors associated with the Suita score within body composition-related parameters (body mass index (BMI), waist circumference (WC), fat mass index, fat-free mass index, fat mass to fat-free mass ratio (F-FF ratio), and water mass index) as assessed by bioelectrical impedance analysis were examined. The mean age of subjects was 54.8 years in men and 52.8 years in women (p < 0.0001). The mean BMI was 23.9 kg/m2 in men and 21.8 kg/m2 in women (p < 0.0001). Diabetes mellitus was found in 1282 subjects (18.7%) among men and 816 subjects (9.4%) among women (p < 0.0001). The mean Suita score was 42.0 in men and 29.6 in women (p < 0.0001). In multivariate analysis, WC (p < 0.0001), F-FF ratio (p < 0.0001), and water mass index (p < 0.0001) were independent factors linked to the Suita score for both genders. In conclusion, body composition can be associated with the Suita score in Japanese adults receiving health check-ups.
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Affiliation(s)
- Saori Onishi
- Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Osaka, Japan (T.N.)
| | - Akira Fukuda
- Health Science Clinic, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Osaka, Japan
| | - Masahiro Matsui
- Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Osaka, Japan (T.N.)
| | - Kosuke Ushiro
- Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Osaka, Japan (T.N.)
| | - Tomohiro Nishikawa
- Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Osaka, Japan (T.N.)
| | - Akira Asai
- Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Osaka, Japan (T.N.)
| | - Soo Ki Kim
- Department of Gastroenterology, Kobe Asahi Hospital, Kobe 653-8501, Hyogo, Japan
| | - Hiroki Nishikawa
- Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Osaka, Japan (T.N.)
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13
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Mangner N, Winzer EB, Linke A, Adams V. Locomotor and respiratory muscle abnormalities in HFrEF and HFpEF. Front Cardiovasc Med 2023; 10:1149065. [PMID: 37965088 PMCID: PMC10641491 DOI: 10.3389/fcvm.2023.1149065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 10/02/2023] [Indexed: 11/16/2023] Open
Abstract
Heart failure (HF) is a chronic and progressive syndrome affecting worldwide billions of patients. Exercise intolerance and early fatigue are hallmarks of HF patients either with a reduced (HFrEF) or a preserved (HFpEF) ejection fraction. Alterations of the skeletal muscle contribute to exercise intolerance in HF. This review will provide a contemporary summary of the clinical and molecular alterations currently known to occur in the skeletal muscles of both HFrEF and HFpEF, and thereby differentiate the effects on locomotor and respiratory muscles, in particular the diaphragm. Moreover, current and future therapeutic options to address skeletal muscle weakness will be discussed focusing mainly on the effects of exercise training.
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Affiliation(s)
- Norman Mangner
- Department of Internal Medicine and Cardiology, Heart Center Dresden, Technische Universität Dresden, Dresden, Germany
| | - Ephraim B. Winzer
- Department of Internal Medicine and Cardiology, Heart Center Dresden, Technische Universität Dresden, Dresden, Germany
| | - Axel Linke
- Department of Internal Medicine and Cardiology, Heart Center Dresden, Technische Universität Dresden, Dresden, Germany
| | - Volker Adams
- Laboratory of Molecular and Experimental Cardiology, Heart Center Dresden, Technische Universität Dresden, Dresden, Germany
- Dresden Cardiovascular Research Institute and Core Laboratories GmbH, Dresden, Germany
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14
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Talha KM, Pandey A, Fudim M, Butler J, Anker SD, Khan MS. Frailty and heart failure: State-of-the-art review. J Cachexia Sarcopenia Muscle 2023; 14:1959-1972. [PMID: 37586848 PMCID: PMC10570089 DOI: 10.1002/jcsm.13306] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 06/16/2023] [Accepted: 07/11/2023] [Indexed: 08/18/2023] Open
Abstract
At least half of all patients with heart failure (HF) are affected by frailty, a syndrome that limits an individual ability to recover from acute stressors. While frailty affects up to 90% of patients with HF with preserved ejection fraction, it is also seen in ~30-60% of patients with HF with reduced ejection fraction, with ~26% higher prevalence in women compared with men. The relationship between frailty and HF is bidirectional, with both conditions exacerbating the other. Frailty is further complicated by a higher prevalence of sarcopenia (by ~20%) in HF patients compared with patients without HF, which negatively affects outcomes. Several frailty assessment methods have been employed historically including the Fried frailty phenotype and Rockwood Clinical Frailty Scale to classify HF patients based on the severity of frailty; however, a validated HF-specific frailty assessment tool does not currently exist. Frailty in HF is associated with a poor prognosis with a 1.5-fold to 2-fold higher risk of all-cause death and hospitalizations compared to non-frail patients. Frailty is also highly prevalent in patients with worsening HF, affecting >50% of patients hospitalized for HF. Such patients with multiple readmissions for decompensated HF have markedly poor outcomes compared to younger, non-frail cohorts, and it is hypothesized that it may be due to major physical and functional limitations that limit recovery from an acute episode of worsening HF, a care aspect that has not been addressed in HF guidelines. Frail patients are thought to confer less benefit from therapeutic interventions due to an increased risk of perceived harm, resulting in lower adherence to HF interventions, which may worsen outcomes. Multiple studies report that <40% of frail patients are on guideline-directed medical therapy for HF, of which most are on suboptimal doses of these medications. There is a lack of evidence generated from randomized trials in this incredibly vulnerable population, and most current practice is governed by post hoc analyses of trials, observational registry-based data and providers' clinical judgement. The current body of evidence suggests that the treatment effect of most guideline-based interventions, including medications, cardiac rehabilitation and device therapy, is consistent across all age groups and frailty subgroups and, in some cases, may be amplified in the older, more frail population. In this review, we discuss the characteristics, assessment tools, impact on prognosis and impact on therapeutic interventions of frailty in patients with HF.
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Affiliation(s)
- Khawaja M. Talha
- Department of MedicineUniversity of Mississippi Medical CenterJacksonMSUSA
| | - Ambarish Pandey
- Division of CardiologyUniversity of Texas Southwestern Medical CenterDallasTXUSA
| | - Marat Fudim
- Division of CardiologyDuke University Hospital, Duke University School of MedicineDurhamNCUSA
- Duke Clinical Research InstituteDurhamNCUSA
| | - Javed Butler
- Department of MedicineUniversity of Mississippi Medical CenterJacksonMSUSA
- Baylor Scott and White Research InstituteDallasTXUSA
| | - Stefan D. Anker
- Department of Cardiology (CVK) of German Heart Center CharitéInstitute of Health Center for Regenerative Therapies (BCRT), German Centre for Cardiovascular Research (DZHK) partner site Berlin, Charité UniversitätsmedizinBerlinGermany
- Institute of Heart DiseasesWroclaw Medical UniversityWroclawPoland
| | - Muhammad Shahzeb Khan
- Division of CardiologyDuke University Hospital, Duke University School of MedicineDurhamNCUSA
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15
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Kubat GB, Bouhamida E, Ulger O, Turkel I, Pedriali G, Ramaccini D, Ekinci O, Ozerklig B, Atalay O, Patergnani S, Nur Sahin B, Morciano G, Tuncer M, Tremoli E, Pinton P. Mitochondrial dysfunction and skeletal muscle atrophy: Causes, mechanisms, and treatment strategies. Mitochondrion 2023; 72:33-58. [PMID: 37451353 DOI: 10.1016/j.mito.2023.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 07/02/2023] [Accepted: 07/11/2023] [Indexed: 07/18/2023]
Abstract
Skeletal muscle, which accounts for approximately 40% of total body weight, is one of the most dynamic and plastic tissues in the human body and plays a vital role in movement, posture and force production. More than just a component of the locomotor system, skeletal muscle functions as an endocrine organ capable of producing and secreting hundreds of bioactive molecules. Therefore, maintaining healthy skeletal muscles is crucial for supporting overall body health. Various pathological conditions, such as prolonged immobilization, cachexia, aging, drug-induced toxicity, and cardiovascular diseases (CVDs), can disrupt the balance between muscle protein synthesis and degradation, leading to skeletal muscle atrophy. Mitochondrial dysfunction is a major contributing mechanism to skeletal muscle atrophy, as it plays crucial roles in various biological processes, including energy production, metabolic flexibility, maintenance of redox homeostasis, and regulation of apoptosis. In this review, we critically examine recent knowledge regarding the causes of muscle atrophy (disuse, cachexia, aging, etc.) and its contribution to CVDs. Additionally, we highlight the mitochondrial signaling pathways involvement to skeletal muscle atrophy, such as the ubiquitin-proteasome system, autophagy and mitophagy, mitochondrial fission-fusion, and mitochondrial biogenesis. Furthermore, we discuss current strategies, including exercise, mitochondria-targeted antioxidants, in vivo transfection of PGC-1α, and the potential use of mitochondrial transplantation as a possible therapeutic approach.
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Affiliation(s)
- Gokhan Burcin Kubat
- Department of Mitochondria and Cellular Research, Gulhane Health Sciences Institute, University of Health Sciences, 06010 Ankara, Turkey.
| | - Esmaa Bouhamida
- Translational Research Center, Maria Cecilia Hospital GVM Care & Research, 48033 Cotignola, Italy
| | - Oner Ulger
- Department of Mitochondria and Cellular Research, Gulhane Health Sciences Institute, University of Health Sciences, 06010 Ankara, Turkey
| | - Ibrahim Turkel
- Department of Exercise and Sport Sciences, Faculty of Sport Sciences, Hacettepe University, 06800 Ankara, Turkey
| | - Gaia Pedriali
- Translational Research Center, Maria Cecilia Hospital GVM Care & Research, 48033 Cotignola, Italy
| | - Daniela Ramaccini
- Translational Research Center, Maria Cecilia Hospital GVM Care & Research, 48033 Cotignola, Italy
| | - Ozgur Ekinci
- Department of Pathology, Gazi University, 06500 Ankara, Turkey
| | - Berkay Ozerklig
- Department of Exercise and Sport Sciences, Faculty of Sport Sciences, Hacettepe University, 06800 Ankara, Turkey
| | - Ozbeyen Atalay
- Department of Physiology, Faculty of Medicine, Hacettepe University, 06230 Ankara, Turkey
| | - Simone Patergnani
- Translational Research Center, Maria Cecilia Hospital GVM Care & Research, 48033 Cotignola, Italy; Department of Medical Sciences, Laboratory for Technologies of Advanced Therapies (LTTA), University of Ferrara, 44121 Ferrara, Italy
| | - Beyza Nur Sahin
- Department of Physiology, Faculty of Medicine, Hacettepe University, 06230 Ankara, Turkey
| | - Giampaolo Morciano
- Translational Research Center, Maria Cecilia Hospital GVM Care & Research, 48033 Cotignola, Italy; Department of Medical Sciences, Laboratory for Technologies of Advanced Therapies (LTTA), University of Ferrara, 44121 Ferrara, Italy
| | - Meltem Tuncer
- Department of Physiology, Faculty of Medicine, Hacettepe University, 06230 Ankara, Turkey
| | - Elena Tremoli
- Translational Research Center, Maria Cecilia Hospital GVM Care & Research, 48033 Cotignola, Italy
| | - Paolo Pinton
- Translational Research Center, Maria Cecilia Hospital GVM Care & Research, 48033 Cotignola, Italy; Department of Medical Sciences, Laboratory for Technologies of Advanced Therapies (LTTA), University of Ferrara, 44121 Ferrara, Italy.
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16
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Sunayama T, Fujimoto Y, Matsue Y, Dotare T, Daichi M, Yatsu S, Ishiwata S, Nakamura Y, Akama Y, Tsujimura Y, Suda S, Kato T, Hiki M, Kasai T, Minamino T. Prognostic value of estimating appendicular muscle mass in heart failure using creatinine/cystatin C. Nutr Metab Cardiovasc Dis 2023; 33:1733-1739. [PMID: 37407312 DOI: 10.1016/j.numecd.2023.05.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 04/29/2023] [Accepted: 05/29/2023] [Indexed: 07/07/2023]
Abstract
BACKGROUND AND AIMS Heart failure with concomitant sarcopenia has a poor prognosis; therefore, simple methods for evaluating the appendicular skeletal muscle mass index (ASMI) are required. Recently, a model incorporating anthropometric data and the sarcopenia index (i.e., serum creatinine-to-cystatin C ratio [Cre/CysC]), was developed to estimate the ASMI. We hypothesized that this model was superior to the traditional model, which uses only anthropometric data to predict prognosis. This retrospective cohort study compared the prognostic value of low ASMI as defined by the biomarker and anthropometric models in patients with heart failure. METHODS AND RESULTS Among 847 patients, we estimated ASMI using an anthropometric model (incorporating age, body weight, and height) in 791 patients and a biomarker model (incorporating age, body weight, hemoglobin, and Cre/CysC) in 562 patients. The primary outcome was all-cause mortality. Overall, 53.4% and 39.1% of patients were diagnosed with low ASMI (using the Asian Working Group for Sarcopenia cut-off) by the anthropometric and biomarker models, respectively. The two models showed a poor agreement in the diagnosis of low ASMI (kappa: 0.57, 95% confidence interval: 0.50-0.63). Kaplan-Meier curves showed that a low ASMI was significantly associated with all-cause death in both models. However, this association was retained after adjustment for other covariates in the biomarker model (hazard ratio: 2.32, p = 0.001) but not in the anthropometric model (hazard ratio: 0.79, p = 0.360). CONCLUSION Among patients hospitalized with heart failure, a low ASMI estimated using the biomarker model, and not the anthropometric model, was significantly associated with all-cause mortality.
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Affiliation(s)
- Tsutomu Sunayama
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yudai Fujimoto
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yuya Matsue
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.
| | - Taishi Dotare
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Maeda Daichi
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Shoichiro Yatsu
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Sayaki Ishiwata
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yutaka Nakamura
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yuka Akama
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yuichiro Tsujimura
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Shoko Suda
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Takao Kato
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Masaru Hiki
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Takatoshi Kasai
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan; Cardiovascular Respiratory Sleep Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Tohru Minamino
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan; Japan Agency for Medical Research and Development-Core Research for Evolutionary Medical Science and Technology (AMED-CREST), Japan Agency for Medical Research and Development, Tokyo, Japan
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17
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Paixão da Silva E, Ranielly Dos Santos Avelino R, Zuza Diniz RV, Dantas de Lira NR, Monteiro Lourenço Queiroz SI, Gomes Dantas Lopes MM, Maurício Sena-Evangelista KC. Body composition, lipid profile and clinical parameters are predictors of prognosis in patients with heart failure: Two-year follow-up. Clin Nutr ESPEN 2023; 56:52-58. [PMID: 37344083 DOI: 10.1016/j.clnesp.2023.04.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 04/16/2023] [Accepted: 04/28/2023] [Indexed: 06/23/2023]
Abstract
BACKGROUND Heart failure (HF) is a complex syndrome that leads to changes in body composition and eventually results in unfavorable outcomes. AIM This study aimed to evaluate body composition, lipid profiles and clinical parameters of patients with HF, and their associations with both survival and unfavorable clinical outcomes. METHODS This prospective cohort study included 94 adults and older people with HF. Body composition was assessed by bioelectrical impedance analysis (BIA). Anthropometric variables and lipid profile were also evaluated. Electronic medical records were checked to collect information on clinical outcomes (mortality and hospitalization), considering a follow-up period of 24 months. Survival was calculated using the Kaplan-Meier estimate, and the curves compared using Log-Rank. The death risk rate (Hazard Ratio, HR) was calculated using Cox's univariate models. RESULTS Mean age was 55.1 (13.9) years and there was a higher frequency of males. There was a predominance of HF with reduced ejection fraction, and ischemic etiology. Patients with New York Heart Association (NYHA) functional classification I/II had a better overall survival rate at 24 months than those with NYHA III/IV (univariate HR 4.93 (1.76-13.82); p = 0.001). Greater survival rates were found in patients without chronic kidney disease (CKD) (univariate HR 2.93 (1.59-5.39); p = 0.01). In the multivariate analyses, both dyslipidemia (adjusted HR 3.84 (1.22-12.00); p = 0.021) and increased fat mass index (FMI) were associated with overall survival rate (adjusted HR 3.59 (1, 10-11.74); p = 0.034). CONCLUSION The severity of HF symptoms and the presence of chronic kidney disease are associated with higher mortality. Increased fat mass index and dyslipidemia are predictors of favorable outcomes in this population.
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Affiliation(s)
- Eduardo Paixão da Silva
- Multiprofessional Residency in Health - Cardiology, Onofre Lopes University Hospital, Federal University of Rio Grande Do Norte (EPS, RRSA, RVZD, NRDL, MMGDL, KCMSE), Brazil
| | - Regina Ranielly Dos Santos Avelino
- Multiprofessional Residency in Health - Cardiology, Onofre Lopes University Hospital, Federal University of Rio Grande Do Norte (EPS, RRSA, RVZD, NRDL, MMGDL, KCMSE), Brazil
| | - Rosiane Viana Zuza Diniz
- Multiprofessional Residency in Health - Cardiology, Onofre Lopes University Hospital, Federal University of Rio Grande Do Norte (EPS, RRSA, RVZD, NRDL, MMGDL, KCMSE), Brazil; Department of Clinical Medicine, Health Sciences Center, Federal University of Rio Grande Do Norte (RVZD), Brazil
| | - Niethia Regina Dantas de Lira
- Multiprofessional Residency in Health - Cardiology, Onofre Lopes University Hospital, Federal University of Rio Grande Do Norte (EPS, RRSA, RVZD, NRDL, MMGDL, KCMSE), Brazil; Brazilian Hospital Services Company. Onofre Lopes University Hospital, Health Sciences Center, Federal University of Rio Grande Do Norte (NRDL), Brazil
| | | | - Márcia Marília Gomes Dantas Lopes
- Multiprofessional Residency in Health - Cardiology, Onofre Lopes University Hospital, Federal University of Rio Grande Do Norte (EPS, RRSA, RVZD, NRDL, MMGDL, KCMSE), Brazil; Department of Nutrition, Health Sciences Center, Federal University of Rio Grande Do Norte (MMGDL, KCMSE), Brazil
| | - Karine Cavalcanti Maurício Sena-Evangelista
- Multiprofessional Residency in Health - Cardiology, Onofre Lopes University Hospital, Federal University of Rio Grande Do Norte (EPS, RRSA, RVZD, NRDL, MMGDL, KCMSE), Brazil; Department of Nutrition, Health Sciences Center, Federal University of Rio Grande Do Norte (MMGDL, KCMSE), Brazil.
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18
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Ohori K, Yano T, Katano S, Nagaoka R, Numazawa R, Yamano K, Fujisawa Y, Kouzu H, Koyama M, Nagano N, Fujito T, Nishikawa R, Ohwada W, Furuhashi M. Independent Association Between Use of Proton Pump Inhibitors and Muscle Wasting in Patients with Heart Failure: A Single-Center, Ambispective, Observational Study. Drugs Aging 2023:10.1007/s40266-023-01035-3. [PMID: 37328671 DOI: 10.1007/s40266-023-01035-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Although proton pump inhibitors (PPIs) play a pivotal role in the prevention and treatment of gastric acid-related diseases and gastrointestinal adverse events caused by antiplatelet therapies, the safety of long-term use of PPIs has been questioned. OBJECTIVE The aim of this study was to determine the effects of use of PPIs on muscle mass and bone mineral density in heart failure (HF) patients. METHODS This was a single-center, ambispective (combined retrospective and prospective), observational study. HF patients (n = 747; 72 years of age; males, 54%) who received a dual-energy x-ray absorptiometry scan were enrolled. Muscle wasting was defined as appendicular skeletal muscle mass index (ASMI) < 7.0 kg/m2 in males and <5.4 kg/m2 in females. Propensity scores for the use of PPIs were calculated using a multivariate logistic regression model to minimize selection bias. RESULTS Before propensity score matching, ASMI was significantly lower in patients receiving PPIs than in patients not receiving PPIs, resulting in a higher prevalence of muscle wasting in the PPI group. Such a relationship between use of PPIs and muscle wasting remained after propensity score matching. In multivariate Cox regression analyses, use of PPIs was independently associated with presence of muscle wasting (hazard ratio 1.68, 95% confidence interval 1.05-2.69) after adjustment for established risk factors of sarcopenia. On the other hand, there were no differences in bone mineral density between the PPI group and the no-PPI group. CONCLUSION Use of PPIs is associated with a high risk of muscle wasting in HF patients. Caution is warranted when long-term PPI treatment is performed in sarcopenic HF patients and HF patients with several risk factors for muscle wasting.
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Affiliation(s)
- Katsuhiko Ohori
- Department of Cardiology, Hokkaido Cardiovascular Hospital, Sapporo, Japan
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan
| | - Toshiyuki Yano
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan.
| | - Satoshi Katano
- Division of Rehabilitation, Sapporo Medical University Hospital, Sapporo, Japan
| | - Ryohei Nagaoka
- Division of Rehabilitation, Sapporo Medical University Hospital, Sapporo, Japan
| | - Ryo Numazawa
- Division of Rehabilitation, Sapporo Medical University Hospital, Sapporo, Japan
| | - Kotaro Yamano
- Division of Rehabilitation, Sapporo Medical University Hospital, Sapporo, Japan
| | - Yusuke Fujisawa
- Division of Rehabilitation, Sapporo Medical University Hospital, Sapporo, Japan
| | - Hidemichi Kouzu
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan
| | - Masayuki Koyama
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan
- Department of Public Health, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Nobutaka Nagano
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan
| | - Takefumi Fujito
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan
| | - Ryo Nishikawa
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan
| | - Wataru Ohwada
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan
| | - Masato Furuhashi
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan
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19
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Fujimoto Y, Maeda D, Kagiyama N, Sunayama T, Dotare T, Jujo K, Saito K, Kamiya K, Saito H, Ogasahara Y, Maekawa E, Konishi M, Kitai T, Iwata K, Wada H, Hiki M, Kasai T, Nagamatsu H, Ozawa T, Izawa K, Yamamoto S, Aizawa N, Wakaume K, Oka K, Momomura SI, Matsue Y. Prevalence and prognostic impact of the coexistence of cachexia and sarcopenia in older patients with heart failure. Int J Cardiol 2023; 381:45-51. [PMID: 36934990 DOI: 10.1016/j.ijcard.2023.03.035] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 03/12/2023] [Accepted: 03/16/2023] [Indexed: 03/21/2023]
Abstract
BACKGROUND No study with an adequate patients' number has examined the relationship/overlap between sarcopenia and cachexia. We examined the prevalence of the overlap and prognostic implications of sarcopenia and cachexia in older patients with heart failure using well-accepted definitions. METHODS This was a post-hoc sub-analysis of the FRAGILE-HF study, a prospective, multicenter, observational study conducted at 15 hospitals in Japan. In total, 905 hospitalized older patients were classified into four groups based on the presence or absence of cachexia and/or sarcopenia, which were defined according to the Evans and Asian Working Group for Sarcopenia criteria revised in 2019, respectively. The primary endpoint was 2-year all-cause mortality. RESULTS Cachexia and sarcopenia prevalence rates were 32.7% and 22.7%, respectively. Patients were classified into the non-cachexia/non-sarcopenia (55.7%), cachexia/non-sarcopenia (21.7%), non-cachexia/sarcopenia (11.6%), and cachexia/sarcopenia (11.0%) groups. During the 2-year follow-up period after discharge, 158 (17.5%) all-cause deaths (124 cardiovascular deaths [CVD] and 34 non-CVD) were observed. The cachexia/sarcopenia group had the lowest body fat mass and exhibited significantly higher mortality rates (log-rank P < 0.001). Cox proportional hazard analysis revealed that cachexia/sarcopenia was an independent prognostic factor after adjusting for known prognostic factors (versus non-cachexia/non-sarcopenia: hazard ratio, 2.78; 95% confidence interval, 1.80-4.29; P < 0.001). Neither cachexia/non-sarcopenia nor non-cachexia/sarcopenia were significantly associated with all-cause mortality compared with non-cachexia/non-sarcopenia. CONCLUSIONS Cachexia and sarcopenia are prevalent among older hospitalized patients with heart failure; nonetheless, the overlap is not as prominent as previously expected. The presence of cachexia and sarcopenia is a risk factor for all-cause mortality.
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Affiliation(s)
- Yudai Fujimoto
- Department of Cardiovascular Medicine, Saitama Medical Centre, Jichi Medical University, Saitama, Japan
| | - Daichi Maeda
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Nobuyuki Kagiyama
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan; Department of Cardiology, The Sakakibara Heart Institute of Okayama, Okayama, Japan; Department of Digital Health and Telemedicine R&D, Juntendo University, Tokyo, Japan
| | - Tsutomu Sunayama
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Taishi Dotare
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Kentaro Jujo
- Department of Cardiology, Nishiarai Heart Centre Hospital, Tokyo, Japan
| | - Kazuya Saito
- Department of Rehabilitation, The Sakakibara Heart Institute of Okayama, Okayama, Japan
| | - Kentaro Kamiya
- Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, Sagamihara, Japan
| | - Hiroshi Saito
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan; Department of Rehabilitation, Kameda Medical Centre, Kamogawa, Japan
| | - Yuki Ogasahara
- Department of Nursing, The Sakakibara Heart Institute of Okayama, Okayama, Japan
| | - Emi Maekawa
- Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Masaaki Konishi
- Division of Cardiology, Yokohama City University Medical Centre, Yokohama, Japan
| | - Takeshi Kitai
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Osaka, Japan; Department of Rehabilitation, Kobe City Medical Centre General Hospital, Kobe, Japan
| | - Kentaro Iwata
- Department of Rehabilitation, Kobe City Medical Centre General Hospital, Kobe, Japan
| | - Hiroshi Wada
- Department of Cardiovascular Medicine, Saitama Medical Centre, Jichi Medical University, Saitama, Japan
| | - Masaru Hiki
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Takatoshi Kasai
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan; Cardiovascular Respiratory Sleep Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Hirofumi Nagamatsu
- Department of Cardiology, Tokai University School of Medicine, Isehara, Japan
| | - Tetsuya Ozawa
- Department of Rehabilitation, Odawara Municipal Hospital, Odawara, Japan
| | - Katsuya Izawa
- Department of Rehabilitation, Matsui Heart Clinic, Japan
| | - Shuhei Yamamoto
- Department of Rehabilitation, Shinshu University Hospital, Matsumoto, Japan
| | - Naoki Aizawa
- Department of Cardiovascular Medicine, Nephrology and Neurology, University of the Ryukyus, Okinawa, Japan
| | - Kazuki Wakaume
- Rehabilitation Centre, Kitasato University Medical Centre, Tokyo, Japan
| | - Kazuhiro Oka
- Department of Rehabilitation, Saitama Citizens Medical Centre, Saitama, Japan
| | | | - Yuya Matsue
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.
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20
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Okamura M, Shimizu M, Yamamoto S, Nishie K, Konishi M. High-intensity interval training versus moderate-intensity continuous training in patients with heart failure: a systematic review and meta-analysis. Heart Fail Rev 2023:10.1007/s10741-023-10316-3. [PMID: 37271780 DOI: 10.1007/s10741-023-10316-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/12/2023] [Indexed: 06/06/2023]
Abstract
The effects of high-intensity interval training (HIIT) in patients with heart failure (HF) remain controversial. This systematic review and meta-analysis aimed to examine the efficacy of HIIT versus moderate-intensity continuous aerobic training (MCT) on exercise tolerance in patients with HF. We searched for studies published up to 4 March 2022 in Embase, MEDLINE, PubMed, and the Cochrane Library with no limitations on data, language, or publication status. We included randomized controlled trials comparing the efficacy of HIIT and MCT on peak oxygen uptake (VO2), as a measure of exercise tolerance. We pooled the data on peak VO2, compared HIIT to MCT, and conducted a sub-analysis if there was heterogeneity in the result. We identified 15 randomized controlled trials with 557 patients. Our meta-analysis showed that participants who underwent HIIT achieved a significantly higher peak VO2 than those who underwent MCT (mean difference 1.46 ml/kg/min, 95% confidence interval 0.39 to 2.53; participants = 557; studies = 15; I2 = 65.7%; very low-quality evidence). The meta-regression analysis, conducted as a sub-analysis to explore possible causes of heterogeneity, revealed that the difference in peak VO2 between HIIT and MCT was inversely associated with body mass index (r = - 0.508, p = 0.028, 95% confidence interval - 0.95 to - 0.07). Our systematic review showed that HIIT achieved a higher peak VO2 than MCT in patients with HF. In addition, HIIT may be more effective in improving exercise tolerance in patients with low body mass index.
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Affiliation(s)
- Masatsugu Okamura
- Berlin Institute of Health Center for Regenerative Therapies (BCRT), Charité - Universitätsmedizin Berlin, Berlin, Germany
- Department of Rehabilitation Medicine, Yokohama City University School of Medicine, Yokohama, Japan
| | - Masashi Shimizu
- Department of Rehabilitation, Osaka Metropolitan University Hospital, Osaka, Japan
| | - Shuhei Yamamoto
- Department of Rehabilitation, Shinshu University Hospital, Matsumoto, Japan
| | - Kenichi Nishie
- Department of Respiratory Medicine, Iida Municipal Hospital, Iida, Japan
| | - Masaaki Konishi
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-Ward, Yokohama, 236-0004, Japan.
- Department of Cardiology, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan.
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21
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Lei S, Li C, She Y, Zhou S, Shi H, Chen R. Roles of super enhancers and enhancer RNAs in skeletal muscle development and disease. Cell Cycle 2023; 22:495-505. [PMID: 36184878 PMCID: PMC9928468 DOI: 10.1080/15384101.2022.2129240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 09/09/2022] [Accepted: 09/21/2022] [Indexed: 11/03/2022] Open
Abstract
Skeletal muscle development is a multistep biological process regulated by a variety of myogenic regulatory factors, including MyoG, MyoD, Myf5, and Myf6 (also known as MRF4), as well as members of the FoxO subfamily. Differentiation and regeneration during skeletal muscle myogenesis contribute to the physiological function of muscles. Super enhancers (SEs) and enhancer RNAs (eRNAs) are involved in the regulation of development and diseases. Few studies have identified the roles of SEs and eRNAs in muscle development and pathophysiology. To develop approaches to enhance skeletal muscle mass and function, a more comprehensive understanding of the key processes underlying muscular diseases is needed. In this review, we summarize the roles of SEs and eRNAs in muscle development and disease through affecting of DNA methylation, FoxO subfamily, RAS-MEK signaling, chromatin modifications and accessibility, MyoD and cis regulating target genes. The summary could inform strategies to increase muscle mass and treat muscle-related diseases.
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Affiliation(s)
- Si Lei
- Guangdong Second Provincial General Hospital, Guangdong Traditional Medical and Sports Injury Rehabilitation Research Institute, Guangzhou, China
| | - Cheng Li
- Guangdong Second Provincial General Hospital, Guangdong Traditional Medical and Sports Injury Rehabilitation Research Institute, Guangzhou, China
| | - Yanling She
- Guangdong Second Provincial General Hospital, Guangdong Traditional Medical and Sports Injury Rehabilitation Research Institute, Guangzhou, China
| | - Shanyao Zhou
- Guangdong Second Provincial General Hospital, Guangdong Traditional Medical and Sports Injury Rehabilitation Research Institute, Guangzhou, China
| | - Huacai Shi
- Guangdong Second Provincial General Hospital, Guangdong Traditional Medical and Sports Injury Rehabilitation Research Institute, Guangzhou, China
| | - Rui Chen
- Guangdong Second Provincial General Hospital, Guangdong Traditional Medical and Sports Injury Rehabilitation Research Institute, Guangzhou, China
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22
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Konishi M, Kaneko H, Itoh H, Matsuoka S, Okada A, Kamiya K, Sugimoto T, Fujiu K, Michihata N, Jo T, Takeda N, Morita H, Tamura K, Yasunaga H, Komuro I. Association of weight change and in-hospital mortality in patients with repeated hospitalization for heart failure. J Cachexia Sarcopenia Muscle 2023; 14:642-652. [PMID: 36564944 PMCID: PMC9891958 DOI: 10.1002/jcsm.13170] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 11/10/2022] [Accepted: 12/04/2022] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Although weight loss in heart failure (HF) is a detrimental condition known as cachexia, weight gain caused by fluid retention should also be considered harmful. However, studies with sufficient number of patients examining the impact of weight change and its interval on in-hospital mortality in HF have not been conducted thus far. We sought to elucidate the association of weight change with in-hospital mortality in patients with HF. METHODS This retrospective observational study used data from the Diagnosis Procedure Combination database, a nationwide inpatient health claims database in Japan. In total, 48 234 patients repeatedly hospitalized for HF (median 82 [74-87] years; 46.4% men) between 2010 and 2018 were included. Weight change was derived from body weight at the first and second admissions. RESULTS The median weight change and interval between two hospitalizations were -3.1 [-8.3 to -1.8] % and 172 [67-420] days, with 66.9% of overall cohort experiencing any weight loss. As a result of multivariable-adjusted logistic regression analysis, weight loss <-5.0% and weight gain >+5.0% were associated with increased in-hospital mortality (adjusted odds ratio [OR] [95% confidence interval]: 1.46 [1.31-1.62], P < 0.001 and 1.23 [1.08-1.40], P = 0.002, respectively) whereas mild weight loss and gain of 2.0-5.0% were not (OR [95% confidence interval]: 0.96 [0.84-1.10], P = 0.57 and 1.07 [0.92-1.25], P = 0.37, respectively), in comparison with patients with a stable weight (fluctuating no more than -2.0% to +2.0%) used as a reference. Restrictive cubic spline models adjusted for multiple background factors illustrated that higher mortality in patients with weight loss was observed across all subgroups of the baseline body mass index (<18.5, 18.5-24.9 and ≥25.0 kg/m2 ). In patients with short (<90 days) and middle (<180 days) intervals between the two hospitalizations, both weight loss and weight gain were associated with high mortality, whereas the association between weight gain and high mortality was attenuated in those with longer intervals. CONCLUSIONS Both weight loss and weight gain in patients with repeated hospitalization for HF were associated with high in-hospital mortality, especially weight loss and short/middle-term weight gain. Such patients should be treated with caution in a setting of repeated hospitalization for HF.
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Affiliation(s)
- Masaaki Konishi
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Hidehiro Kaneko
- Department of Cardiovascular Medicine and Department of Advanced Cardiology, The University of Tokyo, Tokyo, Japan
| | - Hidetaka Itoh
- Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
| | - Satoshi Matsuoka
- Department of Cardiovascular Medicine, New Tokyo Hospital, Matsudo, Japan
| | - Akira Okada
- Department of Prevention of Diabetes and Lifestyle-Related Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kentaro Kamiya
- Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, Sagamihara, Japan
| | - Tadafumi Sugimoto
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Katsuhito Fujiu
- Department of Cardiovascular Medicine and Department of Advanced Cardiology, The University of Tokyo, Tokyo, Japan
| | - Nobuaki Michihata
- Department of Health Services Research, The University of Tokyo, Tokyo, Japan
| | - Taisuke Jo
- Department of Health Services Research, The University of Tokyo, Tokyo, Japan
| | - Norifumi Takeda
- Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
| | - Hiroyuki Morita
- Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
| | - Kouichi Tamura
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Hideo Yasunaga
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Issei Komuro
- Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
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23
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Fuentes-Abolafio IJ, Bernal-López MR, Gómez-Huelgas R, Ricci M, Cuesta-Vargas AI, Pérez-Belmonte LM. Relationship between quadriceps femoris muscle architecture and muscle strength and physical function in older adults with heart failure with preserved ejection fraction. Sci Rep 2022; 12:21660. [PMID: 36522418 PMCID: PMC9755120 DOI: 10.1038/s41598-022-26064-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 12/08/2022] [Indexed: 12/23/2022] Open
Abstract
Heart failure (HF)-related factors potentially lead to sarcopenia. Ultrasound (US) assessment has all the advantages of being used in clinical practice to assess muscle architecture. This study aimed to assess the relationship between the quadriceps femoris (QF) muscle architecture with the gender, age, body mass index (BMI), muscle strength and physical function in older adults with HF with preserved ejection fraction (HFpEF) as well as to assess the difference in these relationships between the two genders. Patients 70 years and older with HFpEF were included. The gender, age and BMI were collected. The QF muscle thickness, the QF muscle echo-intensity, the subcutaneous fat tissue thickness (FT) and the subcutaneous fat tissue echo-intensity were assessed by the US. The six-minute walk test, the short physical performance battery (SPPB), the timed up and go test (TUG), and the gait speed test (UGS) were used to assess physical function. The five-repetitions sit-to-stand test (5-STS) was performed to assess muscle strength. Bivariant Pearson correlations and subsequent multivariate linear regression analysis were conducted. Seventy older adults with HFpEF [81.00 (5.97) years] were recruited. The FT showed a correlation between poor and moderate muscle strength and physical function in women with HFpEF. The FT explained 24.5% of the 5-STS variance, 32.4% of the SPPB variance, 31.5% of the TUG variance, 28.6% of the UGS variance, and 21.4% of the FGS variance in women. The US assessment could allow clinicians to assess muscle architecture biomarkers related to muscle strength and physical function in older adults with HFpEF.Trial registration NCT03909919. April 10, 2019. Retrospectively registered.
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Affiliation(s)
- Iván J. Fuentes-Abolafio
- grid.10215.370000 0001 2298 7828Grupo de Investigación Clinimetría CTS-631, Departamento de Fisioterapia, Facultad de Ciencias de la Salud, Universidad de Málaga, C/Arquitecto Peñalosa, 3, 29071 Málaga, España ,grid.452525.1Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Málaga, España
| | - M. Rosa Bernal-López
- grid.452525.1Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Málaga, España ,grid.411457.2Departamento de Medicina Interna, Hospital Regional Universitario de Málaga, Málaga, España ,grid.413448.e0000 0000 9314 1427CIBER Fisio-Patología de la Obesidad y la Nutrición, Instituto de Salud Carlos III, Madrid, España
| | - Ricardo Gómez-Huelgas
- grid.452525.1Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Málaga, España ,grid.411457.2Departamento de Medicina Interna, Hospital Regional Universitario de Málaga, Málaga, España ,grid.413448.e0000 0000 9314 1427CIBER Fisio-Patología de la Obesidad y la Nutrición, Instituto de Salud Carlos III, Madrid, España
| | - Michele Ricci
- grid.411457.2Departamento de Medicina Interna, Hospital Regional Universitario de Málaga, Málaga, España
| | - Antonio I. Cuesta-Vargas
- grid.10215.370000 0001 2298 7828Grupo de Investigación Clinimetría CTS-631, Departamento de Fisioterapia, Facultad de Ciencias de la Salud, Universidad de Málaga, C/Arquitecto Peñalosa, 3, 29071 Málaga, España ,grid.452525.1Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Málaga, España ,grid.1024.70000000089150953School of Clinical Sciences, Faculty of Health at the Queensland University of Technology, Brisbane, QLD Australia
| | - Luis M. Pérez-Belmonte
- grid.452525.1Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Málaga, España ,grid.411457.2Departamento de Medicina Interna, Hospital Regional Universitario de Málaga, Málaga, España ,grid.10215.370000 0001 2298 7828Unidad de Neurofisiología Cognitiva, Centro de Investigaciones Médico Sanitarias (CIMES), Universidad de Málaga (UMA), Campus de Excelencia Internacional (CEI) Andalucía Tech, Málaga, España ,grid.413448.e0000 0000 9314 1427Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, España
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24
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Wang L, Yin L, Yang M, Cheng X. Muscle composition and the imminent mortality risk after hip fracture. J Cachexia Sarcopenia Muscle 2022; 13:2752-2753. [PMID: 36259275 PMCID: PMC9745496 DOI: 10.1002/jcsm.13090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Affiliation(s)
- Ling Wang
- Department of Radiology, Beijing Jishuitan Hospital, Beijing, China
| | - Lu Yin
- Medical Research & Biometrics Center, National Center for Cardiovascular Disease, Beijing, China
| | - Minghui Yang
- Departments of Traumatic Orthopedics, Beijing Jishuitan Hospital, Beijing, China
| | - Xiaoguang Cheng
- Department of Radiology, Beijing Jishuitan Hospital, Beijing, China
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25
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Sato R, Vatic M, da Fonseca GWP, von Haehling S. Sarcopenia and Frailty in Heart Failure: Is There a Biomarker Signature? Curr Heart Fail Rep 2022; 19:400-411. [PMID: 36261756 DOI: 10.1007/s11897-022-00575-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/10/2022] [Indexed: 10/24/2022]
Abstract
PURPOSE OF REVIEW Sarcopenia and frailty are common in patients with heart failure (HF) and are strongly associated with prognosis. This review aims to examine promising biomarkers that can guide physicians in identifying sarcopenia and frailty in HF. RECENT FINDINGS Traditional biomarkers including C-reactive protein, aminotransaminase, myostatin, and urinary creatinine as well as novel biomarkers including microRNAs, suppression of tumorigenicity 2 (ST2), galectin-3, and procollagen type III N-terminal peptide may help in predicting the development of sarcopenia and frailty in HF patients. Among those biomarkers, aminotransferase, urinary creatinine, and ST2 predicted the prognosis in HF patients with sarcopenia and frailty. This review outlines the current knowledge of biomarkers that are considered promising for diagnosing sarcopenia and frailty in HF. The listed biomarkers might support the diagnosis, prognosis, and therapeutic decisions for sarcopenia and frailty in HF patients.
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Affiliation(s)
- Ryosuke Sato
- Department of Cardiology and Pneumology, University of Göttingen Medical Center, Robert-Koch-Str. 40, 37075, Gottingen, Germany
| | - Mirela Vatic
- Department of Cardiology and Pneumology, University of Göttingen Medical Center, Robert-Koch-Str. 40, 37075, Gottingen, Germany
| | | | - Stephan von Haehling
- German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, Gottingen, Germany.
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26
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Konishi M, Akiyama E, Matsuzawa Y, Sato R, Kikuchi S, Nakahashi H, Okada K, Iwahashi N, Kosuge M, Ebina T, Hibi K, Misumi T, Tamura K, Kimura K. Prognostic impact of upper and lower extremity muscle mass in heart failure. ESC Heart Fail 2022; 10:732-737. [PMID: 36221798 PMCID: PMC9871713 DOI: 10.1002/ehf2.14195] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 09/10/2022] [Accepted: 10/02/2022] [Indexed: 01/29/2023] Open
Abstract
AIMS Reduced skeletal muscle mass is a major component of sarcopenia, associated with impaired exercise capacity and poor prognosis in patients with heart failure (HF). Measurement of skeletal muscle mass by dual-energy X-ray absorptiometry may be affected by fluid retention, typically in the patients' lower extremities. The aim of the present study was to elucidate the association between upper and lower extremity skeletal muscle mass (USM and LSM) and all-cause mortality in hospitalized patients with HF, after discharge. METHODS This was a single-centre observational cohort study of 418 patients (59% were men) admitted with a diagnosis of HF (71 ± 13 years), with a left ventricular ejection fraction of 39 ± 16%. USM and LSM were measured by dual-energy X-ray absorptiometry with patients in a stable state after decongestion therapy. RESULTS The USM and LSM were 5.29 ± 1.18 and 13.78 ± 3.20 kg for men and 3.37 ± 0.68 and 9.19 ± 1.80 kg for women. A positive correlation was obtained between USM and LSM with mid-upper arm circumference (r = 0.684, P < 0.001) and calf circumference (r = 0.822, P < 0.001), respectively. During a median follow-up of 37 months, 92 (22.0%) of the 418 patients died. A Kaplan-Meier analysis revealed that sex-specific quartiles of USM/height2 and LSM/height2 were associated with all-cause mortality (both P < 0.001 by the log-rank test). In Cox models adjusted by age, sex, creatinine, haemoglobin, NYHA class, and height2 , the hazard ratio with 95% confidence intervals for all-cause mortality was 0.557 [0.393-0.783] (P < 0.001) for USM per 1 kg, and 0.783 [0.689-0.891] (P < 0.001) for LSM per 1 kg. The receiver-operator-characteristic curve analysis showed a comparable area under the curve between the USM/height2 and LSM/height2 (0.557 vs. 0.568, P = 0.562) in predicting all-cause mortality. The ratio of USM to LSM was significantly lower in 37 patients with residual leg oedema than in the 360 patients without oedema (36.1% vs. 38.1%, P = 0.004), suggesting the influence of oedema on measured LSM. CONCLUSIONS Both USM and LSM had a prognostic implication on mortality after discharge in HF, even though LSM may have been affected by leg oedema. These findings indicate that clinicians should not ignore a patient's USM or LSM in the prognostication of patients with HF.
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Affiliation(s)
- Masaaki Konishi
- Department of Medical Science and Cardiorenal MedicineYokohama City University Graduate School of MedicineYokohamaJapan
| | - Eiichi Akiyama
- Division of CardiologyYokohama City University Medical CenterYokohamaJapan,Kawaguchi Cardiovascular and Respiratory HospitalKawaguchiJapan
| | - Yasushi Matsuzawa
- Division of CardiologyYokohama City University Medical CenterYokohamaJapan
| | - Ryosuke Sato
- Division of CardiologyYokohama City University Medical CenterYokohamaJapan
| | - Shinnosuke Kikuchi
- Division of CardiologyYokohama City University Medical CenterYokohamaJapan
| | - Hidefumi Nakahashi
- Division of CardiologyYokohama City University Medical CenterYokohamaJapan
| | - Kozo Okada
- Division of CardiologyYokohama City University Medical CenterYokohamaJapan
| | - Noriaki Iwahashi
- Division of CardiologyYokohama City University Medical CenterYokohamaJapan
| | - Masami Kosuge
- Division of CardiologyYokohama City University Medical CenterYokohamaJapan
| | - Toshiaki Ebina
- Division of CardiologyYokohama City University Medical CenterYokohamaJapan
| | - Kiyoshi Hibi
- Division of CardiologyYokohama City University Medical CenterYokohamaJapan
| | - Toshihiro Misumi
- Department of BiostatisticsYokohama City University School of MedicineYokohamaJapan
| | - Kouichi Tamura
- Department of Medical Science and Cardiorenal MedicineYokohama City University Graduate School of MedicineYokohamaJapan
| | - Kazuo Kimura
- Division of CardiologyYokohama City University Medical CenterYokohamaJapan,Yokosuka City HospitalYokosukaJapan
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27
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Lee D. Comment on: Obesity is Associated with Improved Postoperative Overall Survival, Independent of Skeletal Muscle Mass in Lung Adenocarcinoma by Lee et al. J Cachexia Sarcopenia Muscle 2022; 13:2576-2578. [PMID: 35965371 PMCID: PMC9530545 DOI: 10.1002/jcsm.13060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Duk‐Hee Lee
- Department of Preventive Medicine, School of MedicineKyungpook National UniversityDaeguSouth Korea
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28
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Katano S, Honma S, Nagaoka R, Numazawa R, Yamano K, Fujisawa Y, Ohori K, Kouzu H, Hashimoto A, Katayose M, Yano T. Anthropometric parameters-derived estimation of muscle mass predicts all-cause mortality in heart failure patients. ESC Heart Fail 2022; 9:4358-4365. [PMID: 36065759 PMCID: PMC9773643 DOI: 10.1002/ehf2.14121] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 07/23/2022] [Accepted: 08/15/2022] [Indexed: 01/19/2023] Open
Abstract
AIMS Reduction in appendicular skeletal muscle mass index (ASMI) assessed by dual-energy X-ray absorptiometry (DEXA) has been shown to be independently associated with a higher mortality rate in patients with heart failure (HF). However, DEXA is not suitable for measurement of muscle mass in a daily clinical setting and in large population-based studies. The aim of this study was to determine whether ASMI predicted from anthropometric indicators (predicted ASMI) serves as an alternative to DEXA-measured ASMI for predicting all-cause death in HF patients. METHODS AND RESULTS Data for 539 HF patients who received a DEXA scan and measurements of calf circumferences (CC) and mid-arm circumferences (MAC) in our hospital were analysed. Predicted ASMI was calculated as we previously reported: predicted ASMI (kg/m2 ) = [0.214 × weight (kg) + 0.217 × CC (cm) - 0.189 × MAC (cm) + 1.098 (male = 1, female = -1) + 0.576]/height2 (m2 ). Low ASMI values were defined as <7.00 kg/m2 and <5.40 kg/m2 for men and women, respectively, according to the criteria of the Asian Working Group for Sarcopenia. The median follow-up period was 1.75 years (interquartile range, 0.96-2.37 years), and 79 patients (15%) died. Kaplan-Meier survival curves showed that patients with low DEXA-measured ASMI and patients with low predicted ASMI had significantly lower survival rates than those for patients with high ASMI. In multivariate Cox proportional hazard analyses adjusted for age, sex, logarithmic B-type natriuretic peptide, cystatin C based-estimated glomerular filtration rate, and gait speed, DEXA-measured ASMI [hazard ratio (HR), 0.982; 95% confidence interval (CI), 0.967-0.998; P = 0.026] and predicted ASMI (HR, 0.979; 95% CI, 0.962-0.996; P = 0.018) were independent predictors of all-cause mortality. Inclusion of predicted ASMI into the adjustment model significantly improved continuous net reclassification improvement (0.338; 95% CI, 0.103-0.572; P < 0.01) and integrated discrimination improvement (0.020; 95% CI, 0.004-0.035; P < 0.05) for predicting mortality after discharge. CONCLUSIONS Predicted ASMI, as well as DEXA-measured ASMI, can predict all-cause death in HF patients, and calculation of predicted ASMI will be useful for detecting high-risk patients in a daily clinical setting and in large population-based studies.
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Affiliation(s)
- Satoshi Katano
- Division of RehabilitationSapporo Medical University HospitalSapporoJapan
| | - Suguru Honma
- Department of RehabilitationSapporo Cardiovascular HospitalSapporoJapan
| | - Ryohei Nagaoka
- Division of RehabilitationSapporo Medical University HospitalSapporoJapan
| | - Ryo Numazawa
- Division of RehabilitationSapporo Medical University HospitalSapporoJapan
| | - Kotaro Yamano
- Division of RehabilitationSapporo Medical University HospitalSapporoJapan
| | - Yusuke Fujisawa
- Division of RehabilitationSapporo Medical University HospitalSapporoJapan
| | - Katsuhiko Ohori
- Department of Cardiovascular, Renal and Metabolic MedicineSapporo Medical University School of MedicineSapporoJapan,Department of CardiologyHokkaido Cardiovascular HospitalSapporoJapan
| | - Hidemichi Kouzu
- Department of Cardiovascular, Renal and Metabolic MedicineSapporo Medical University School of MedicineSapporoJapan
| | - Akiyoshi Hashimoto
- Department of Cardiovascular, Renal and Metabolic MedicineSapporo Medical University School of MedicineSapporoJapan,Division of Health Care Administration and ManagementSapporo Medical University School of MedicineSapporoJapan
| | - Masaki Katayose
- Second Division of Physical TherapySapporo Medical University School of Health SciencesSapporoJapan
| | - Toshiyuki Yano
- Department of Cardiovascular, Renal and Metabolic MedicineSapporo Medical University School of MedicineSapporoJapan
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29
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Saito H, Matsue Y, Maeda D, Kasai T, Kagiyama N, Endo Y, Zoda M, Mizukami A, Yoshioka K, Hashimoto T, Ishikawa K, Minamino T. Prognostic values of muscle mass assessed by dual-energy X-ray absorptiometry and bioelectrical impedance analysis in older patients with heart failure. Geriatr Gerontol Int 2022; 22:610-615. [PMID: 35751442 DOI: 10.1111/ggi.14424] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 03/23/2022] [Accepted: 05/23/2022] [Indexed: 11/26/2022]
Abstract
AIM This study aimed to compare bioelectrical impedance analysis (BIA) and dual-energy X-ray absorptiometry (DEXA) in measuring skeletal muscle mass (MM), and its prognostic implications in old patients with heart failure. METHODS We prospectively evaluated MM measured by both BIA and DEXA in 226 hospitalized elderly (≥65 years) patients with heart failure. The cut-off values proposed by the Asian Working Group in Sarcopenia were used to define low MM. The prognostic endpoint was all-cause death. RESULTS The median age of the cohort was 82 years (interquartile range: 75-87), and 51.8% of patients were men. According to the BIA and DEXA, 177 (78.3%) and 120 (53.1%) patients were diagnosed with low MM, respectively, and the two assessment tools showed poor agreement (Cohen's kappa coefficient: 0.294). During the follow-up, 32 patients (14.2%) died; only low MM defined by DEXA (hazard ratio 2.45, 95% confidence interval 1.05-5.72, P = 0.039), but not BIA (hazard ratio 1.03, 95% confidence interval 0.35-3.06, P = 0.955), was associated with poor prognosis after adjusting for pre-existing risk factors. Moreover, low MM defined by DEXA (net reclassification improvement: 0.58, P < 0.001), but not BIA (net reclassification improvement: -0.005, P = 0.975), provides incremental prognostic predictability when considered with pre-existing risk factors and brain natriuretic peptide level at discharge. CONCLUSIONS In elderly hospitalized patients with heart failure, low MM defined by DEXA and BIA show significant discordance. The MM defined by DEXA, but not BIA, provides additional prognostic value to pre-existing prognostic models. Geriatr Gerontol Int ••; ••: ••-•• Geriatr Gerontol Int 2022; ••: ••-••.
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Affiliation(s)
- Hiroshi Saito
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Department of Rehabilitation, Kameda Medical center, Chiba, Japan
| | - Yuya Matsue
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Cardiovascular Respiratory Sleep Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Daichi Maeda
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Department of Cardiology, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Takatoshi Kasai
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Cardiovascular Respiratory Sleep Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Nobuyuki Kagiyama
- Department of Digital Health and Telemedicine R&D, Juntendo University, Tokyo, Japan.,Department of Cardiovascular Biology and Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Yoshiko Endo
- Department of Rehabilitation, Kameda Medical center, Chiba, Japan
| | - Masato Zoda
- Department of Rehabilitation, Kameda Medical center, Chiba, Japan
| | - Akira Mizukami
- Department of Cardiology, Kameda Medical Center, Chiba, Japan
| | - Kenji Yoshioka
- Department of Cardiology, Kameda Medical Center, Chiba, Japan
| | | | - Kazuya Ishikawa
- Department of Diagnostic Radiology, Kameda Medical Center, Chiba, Japan
| | - Tohru Minamino
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Japan Agency for Medical Research and Development-Core Research for Evolutionary Medical Science and Technology (AMED-CREST), Japan Agency for Medical Research and Development, Tokyo, Japan
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30
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Huang Y, Wang HY, Jian W, Yang ZJ, Gui C. Development and validation of a nomogram to predict the risk of death within 1 year in patients with non-ischemic dilated cardiomyopathy: a retrospective cohort study. Sci Rep 2022; 12:8513. [PMID: 35595787 PMCID: PMC9123170 DOI: 10.1038/s41598-022-12249-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 05/03/2022] [Indexed: 12/04/2022] Open
Abstract
Predicting the chances mortality within 1 year in non-ischemic dilated cardiomyopathy patients can be very useful in clinical decision-making. This study has developed and validated a risk-prediction model for identifying factors contributing to mortality within 1 year in such patients. The predictive nomogram was constructed using a retrospective cohort study, with 615 of patients hospitalized in the First Affiliated Hospital of Guangxi Medical University between October 2012 and May 2020. A variety of factors, including presence of comorbidities, demographics, results of laboratory tests, echocardiography data, medication strategies, and instances of heart transplant or death were collected from electronic medical records and follow-up telephonic consultations. The least absolute shrinkage and selection operator and logistic regression analyses were used to identify the critical clinical factors for constructing the nomogram. Calibration, discrimination, and clinical usefulness of the predictive model were assessed using the calibration plot, C-index and decision curve analysis. Internal validation was assessed with bootstrapping validation. Among the patients from whom follow-up data were obtained, the incidence of an end event (deaths or heart transplantation within 1 year) was 171 cases per 1000 person-years (105 out of 615). The main predictors included in the nomogram were pulse pressure, red blood cell count, left ventricular end-diastolic dimension, levels of N-terminal pro b-type natriuretic peptide, medical history, in-hospital worsening heart failure, and use of angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers. The model showed excellent discrimination with a C-index of 0.839 (95% CI 0.799-0.879), and the calibration curve demonstrated good agreement. The C-index of internal validation was 0.826, which demonstrated that the model was quite efficacious. A decision curve analysis confirmed that our nomogram was clinically useful. In this study, we have developed a nomogram that can predict the risk of death within 1 year in patients with non-ischemic dilated cardiomyopathy. This will be useful in the early identification of patients in the terminal stages for better individualized clinical decisions.
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Affiliation(s)
- Yuan Huang
- Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, No 6 Shuangyong Road, Nanning, Guangxi, 530021, People's Republic of China
- Guangxi Key Laboratory Base of Precision Medicine in Cardio-Cerebrovascular Diseases Control and Prevention, No 6 Shuangyong Road, Nanning, Guangxi, 530021, People's Republic of China
- Guangxi Clinical Research Center for Cardio-Cerebrovascular Diseases, No 6 Shuangyong Road, Nanning, Guangxi, 530021, People's Republic of China
| | - Hai-Yan Wang
- Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, No 6 Shuangyong Road, Nanning, Guangxi, 530021, People's Republic of China
- Guangxi Key Laboratory Base of Precision Medicine in Cardio-Cerebrovascular Diseases Control and Prevention, No 6 Shuangyong Road, Nanning, Guangxi, 530021, People's Republic of China
- Guangxi Clinical Research Center for Cardio-Cerebrovascular Diseases, No 6 Shuangyong Road, Nanning, Guangxi, 530021, People's Republic of China
| | - Wen Jian
- Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, No 6 Shuangyong Road, Nanning, Guangxi, 530021, People's Republic of China
- Guangxi Key Laboratory Base of Precision Medicine in Cardio-Cerebrovascular Diseases Control and Prevention, No 6 Shuangyong Road, Nanning, Guangxi, 530021, People's Republic of China
- Guangxi Clinical Research Center for Cardio-Cerebrovascular Diseases, No 6 Shuangyong Road, Nanning, Guangxi, 530021, People's Republic of China
| | - Zhi-Jie Yang
- Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, No 6 Shuangyong Road, Nanning, Guangxi, 530021, People's Republic of China
- Guangxi Key Laboratory Base of Precision Medicine in Cardio-Cerebrovascular Diseases Control and Prevention, No 6 Shuangyong Road, Nanning, Guangxi, 530021, People's Republic of China
- Guangxi Clinical Research Center for Cardio-Cerebrovascular Diseases, No 6 Shuangyong Road, Nanning, Guangxi, 530021, People's Republic of China
| | - Chun Gui
- Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, No 6 Shuangyong Road, Nanning, Guangxi, 530021, People's Republic of China.
- Guangxi Key Laboratory Base of Precision Medicine in Cardio-Cerebrovascular Diseases Control and Prevention, No 6 Shuangyong Road, Nanning, Guangxi, 530021, People's Republic of China.
- Guangxi Clinical Research Center for Cardio-Cerebrovascular Diseases, No 6 Shuangyong Road, Nanning, Guangxi, 530021, People's Republic of China.
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31
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Yamamoto E, Kato T, Yaku H, Morimoto T, Inuzuka Y, Tamaki Y, Ozasa N, Yoshikawa Y, Kitai T, Taniguchi R, Iguchi M, Kato M, Takahashi M, Jinnai T, Ikeda T, Nagao K, Kawai T, Komasa A, Nishikawa R, Kawase Y, Morinaga T, Kawato M, Seko Y, Shiba M, Toyofuku M, Furukawa Y, Nakagawa Y, Ando K, Kadota K, Shizuta S, Ono K, Sato Y, Kuwahara K, Kimura T. Appetite loss at discharge from acute decompensated heart failure: Observation from KCHF registry. PLoS One 2022; 17:e0267327. [PMID: 35511913 PMCID: PMC9071124 DOI: 10.1371/journal.pone.0267327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 04/07/2022] [Indexed: 11/26/2022] Open
Abstract
Objective The complex link between nutritional status, protein and lipid synthesis, and immunity plays an important prognostic role in patients with heart failure. However, the association between appetite loss at discharge and long-term outcome remains unclear. Methods The Kyoto Congestive Heart Failure registry is a prospective cohort study that enrolled consecutive patients hospitalized for acute decompensated heart failure (ADHF) in Japan. We assessed 3528 patients alive at discharge, and for whom appetite and follow-up data were available. We compared one-year clinical outcomes in patients with and without appetite loss at discharge. Results In the multivariable logistic regression analysis using 19 clinical and laboratory factors with P value < 0.1 by univariate analysis, BMI < 22 kg/m2 (odds ratio (OR): 1.57, 95% confidence interval (CI): 1.11–2.24, P = 0.01), CRP >1.0mg/dL (OR: 1.49, 95%CI: 1.04–2.14, P = 0.03), and presence of edema at discharge (OR: 4.30, 95%CI: 2.99–6.22, P<0.001) were associated with an increased risk of appetite loss at discharge, whereas ambulatory status (OR: 0.57, 95%CI: 0.39–0.83, P = 0.004) and the use of ACE-I/ARB (OR: 0.70, 95% CI: 0.50–0.98, P = 0.04) were related to a decreased risk in the presence of appetite loss. The cumulative 1-year incidence of all-cause death (primary outcome measure) was significantly higher in patients with appetite loss than in those without appetite loss (31.0% vs. 15.0%, P<0.001). The excess adjusted risk of appetite loss relative to no appetite loss remained significant for all-cause death (hazard ratio (HR): 1.63, 95%CI: 1.29–2.07, P<0.001). Conclusions Loss of appetite at discharge was associated with worse 1-year mortality in patients with ADHF. Appetite is a simple, reliable, and useful subjective marker for risk stratification of patients with ADHF.
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Affiliation(s)
- Erika Yamamoto
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Takao Kato
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
- * E-mail:
| | - Hidenori Yaku
- Department of Cardiology, Mitsubishi Kyoto Hospital, Kyoto, Japan
| | - Takeshi Morimoto
- Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan
| | - Yasutaka Inuzuka
- Department of Cardiovascular Medicine, Shiga General Hospital, Shiga, Japan
| | - Yodo Tamaki
- Division of Cardiology, Tenri Hospital, Nara, Japan
| | - Neiko Ozasa
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yusuke Yoshikawa
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Takeshi Kitai
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Ryoji Taniguchi
- Department of Cardiology, Hyogo Prefectural Amagasaki General Medical Center, Hyogo, Japan
| | - Moritake Iguchi
- Department of Cardiology, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Masashi Kato
- Department of Cardiology, Mitsubishi Kyoto Hospital, Kyoto, Japan
| | | | - Toshikazu Jinnai
- Department of Cardiology, Japanese Red Cross Otsu Hospital, Shiga, Japan
| | - Tomoyuki Ikeda
- Department of Cardiology, Hikone Municipal Hospital, Shiga, Japan
| | - Kazuya Nagao
- Department of Cardiology, Osaka Red Cross Hospital, Osaka, Japan
| | - Takafumi Kawai
- Department of Cardiology, Kishiwada City Hospital, Osaka, Japan
| | - Akihiro Komasa
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Ryusuke Nishikawa
- Department of Cardiology, Shizuoka General Hospital, Shizuoka, Japan
| | - Yuichi Kawase
- Department of Cardiology, Kurashiki Central Hospital, Okayama, Japan
| | - Takashi Morinaga
- Department of Cardiology, Kokura Memorial Hospital, Fukuoka, Japan
| | - Mitsunori Kawato
- Department of Cardiology, Kobe City Nishi-Kobe Medical Center, Hyogo, Japan
| | - Yuta Seko
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Masayuki Shiba
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Mamoru Toyofuku
- Department of Cardiology, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan
| | - Yutaka Furukawa
- Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Hyogo, Japan
| | - Yoshihisa Nakagawa
- Department of Cardiovascular Medicine, Shiga University of Medical Science, Shizuoka, Japan
| | - Kenji Ando
- Department of Cardiology, Kokura Memorial Hospital, Fukuoka, Japan
| | - Kazushige Kadota
- Department of Cardiology, Kurashiki Central Hospital, Okayama, Japan
| | - Satoshi Shizuta
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Koh Ono
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yukihito Sato
- Department of Cardiology, Hyogo Prefectural Amagasaki General Medical Center, Hyogo, Japan
| | - Koichiro Kuwahara
- Department of Cardiovascular Medicine, Shinshu University Graduate School of Medicine, Matsumoto, Japan
| | - Takeshi Kimura
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
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32
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Arm lean mass measured using dual-energy X-ray absorptiometry to predict mortality in older patients with heart failure. Arch Gerontol Geriatr 2022; 101:104689. [DOI: 10.1016/j.archger.2022.104689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 03/11/2022] [Accepted: 03/16/2022] [Indexed: 11/17/2022]
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33
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Ge Y, Liu J, Zhang L, Gao Y, Wang B, Wang X, Li J, Zheng X. Association of Lean Body Mass and Fat Mass With 1-Year Mortality Among Patients With Heart Failure. Front Cardiovasc Med 2022; 9:824628. [PMID: 35295256 PMCID: PMC8918916 DOI: 10.3389/fcvm.2022.824628] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 02/07/2022] [Indexed: 01/05/2023] Open
Abstract
BackgroundPrior studies have found an unexplained inverse or U-shaped relationship between body mass index (BMI) and mortality in heart failure (HF) patients. However, little is known about the independent effects of each body component, i.e., lean body mass (LBM) and fat mass (FM), on mortality.MethodsWe used data from the China Patient-centered Evaluative Assessment of Cardiac Events-Prospective Heart Failure Study. LBM and FM were calculated using equations developed from the National Health and Nutrition Examination Survey. LBM and FM index, calculated by dividing LBM or FM in kilograms by the square of height in meters, were used for analysis. We used restricted cubic spline and Cox model to examine the association of LBM and FM index with 1-year all-cause mortality.ResultsAmong 4,305 patients, median (interquartile range) age was 67 (57–76) years, 37.7% were women. During the 1-year follow-up, 691 (16.1%) patients died. After adjustments, LBM index was inversely associated with mortality in a linear way (P-overall association < 0.01; P-non-linearity = 0.52), but no association between FM index and mortality was observed (P-overall association = 0.19). Compared with patients in the 1st quartile of the LBM index, those in the 2nd, 3rd, and 4th quartiles had lower risk of death, with hazard ratio of 0.80 (95% CI 0.66–0.97), 0.65 (95% CI 0.52–0.83), and 0.61 (95% CI 0.45–0.82), respectively. In contrast, this association was not observed between FM index quartiles and mortality.ConclusionHigher LBM, not FM, was associated with lower 1-year mortality among HF patients.
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Affiliation(s)
- Yilan Ge
- National Center for Cardiovascular Diseases, National Clinical Research Center for Cardiovascular Diseases, NHC Key Laboratory of Clinical Research for Cardiovascular Medications, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jiamin Liu
- National Center for Cardiovascular Diseases, National Clinical Research Center for Cardiovascular Diseases, NHC Key Laboratory of Clinical Research for Cardiovascular Medications, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lihua Zhang
- National Center for Cardiovascular Diseases, National Clinical Research Center for Cardiovascular Diseases, NHC Key Laboratory of Clinical Research for Cardiovascular Medications, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yan Gao
- National Center for Cardiovascular Diseases, National Clinical Research Center for Cardiovascular Diseases, NHC Key Laboratory of Clinical Research for Cardiovascular Medications, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Bin Wang
- National Center for Cardiovascular Diseases, National Clinical Research Center for Cardiovascular Diseases, NHC Key Laboratory of Clinical Research for Cardiovascular Medications, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiuling Wang
- National Center for Cardiovascular Diseases, National Clinical Research Center for Cardiovascular Diseases, NHC Key Laboratory of Clinical Research for Cardiovascular Medications, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jing Li
- National Center for Cardiovascular Diseases, National Clinical Research Center for Cardiovascular Diseases, NHC Key Laboratory of Clinical Research for Cardiovascular Medications, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Jing Li
| | - Xin Zheng
- National Center for Cardiovascular Diseases, National Clinical Research Center for Cardiovascular Diseases, NHC Key Laboratory of Clinical Research for Cardiovascular Medications, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- National Clinical Research Center for Cardiovascular Diseases, Coronary Artery Disease Center, Fuwai Hospital, Chinese Academy of Medical Sciences, Shenzhen, China
- *Correspondence: Xin Zheng
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Cai J, Wang QM, Li JW, Xu F, Bu YL, Wang M, Lu X, Gao W. Serum Meteorin-like is associated with weight loss in the elderly patients with chronic heart failure. J Cachexia Sarcopenia Muscle 2022; 13:409-417. [PMID: 34806347 PMCID: PMC8818622 DOI: 10.1002/jcsm.12865] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 10/03/2021] [Accepted: 10/22/2021] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Unintentional weight loss (cachexia) has been associated with poor outcomes in chronic heart failure (CHF). Meteorin-like (Metrnl) is a novel myokine with protective effects on cardiovascular diseases. However, the change of Metrnl concentrations and its role in elderly patients with CHF remains unclear. The aim of this study was to evaluate the association of serum Metrnl with weight loss and outcomes in elderly patients with CHF. METHODS A total of 931 consecutive elderly patients (aged 60 years and older) with CHF and 135 age-matched and sex-matched control subjects were enrolled. Serum Metrnl concentration was measured by enzyme-linked immunosorbent assay. Body weight was measured at baseline and 12 months. RESULTS Median of serum Metrnl levels was lower in CHF patients when compared with controls [201.31 (184.95-261.16) pg/mL vs. 168.68 (103.15-197.54) pg/mL, P < 0.001]. Patients with the lowest levels of Metrnl had higher N-terminal pro brain natriuretic peptide (NT-proBNP) levels but lower left ventricular eject fraction (LVEF) and estimated glomerular filtration rate (P < 0.001). Lower serum Metrnl was associated with a higher risk of >5% weight loss from baseline to 12 months [odds ratio = 6.13, 95% confidence interval (CI) = 2.57-14.62 per log decrease; P < 0.001]. Serum Metrnl levels were decreased as LVEF decreased (P < 0.001) and were positively correlated with LVEF (r = 0.267, P < 0.001) but negatively correlated with NT-proBNP levels (r = -0.257, P < 0.001). Cox regression analysis suggested that lower serum Metrnl was associated with higher cardiovascular mortality [hazard ratio (HR) = 6.71, 95% CI = 3.41-13.18 per log decrease; P < 0.001], CHF rehospitalization (HR = 3.07, 95% CI = 1.82-5.17 per log decrease; P < 0.001), and the combined major adverse cardiac event(s) (MACEs) (HR = 5.38, 95% CI = 3.51-8.25 per log decrease; P < 0.001). The Kaplan-Meier survival curves showed that low concentration of Metrnl was a prognostic indicator of MACEs in patients with CHF. CONCLUSIONS Our study suggests that lower serum Metrnl level is correlated with weight loss and the severity of cardiac dysfunction in elderly patients with CHF.
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Affiliation(s)
- Juan Cai
- Department of Cardiology, Nantong Hospital of Traditional Chinese Medicine, Nantong, China
| | - Qi-Ming Wang
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Jia-Wen Li
- Department of Geriatrics, Sir Run Run Hospital, Nanjing Medical University, Nanjing, China.,Key Laboratory for Aging & Disease, Nanjing Medical University, Nanjing, China
| | - Fan Xu
- Department of Geriatrics, Sir Run Run Hospital, Nanjing Medical University, Nanjing, China.,Key Laboratory for Aging & Disease, Nanjing Medical University, Nanjing, China
| | - Yun-Ling Bu
- Department of Geriatrics, Sir Run Run Hospital, Nanjing Medical University, Nanjing, China.,Key Laboratory for Aging & Disease, Nanjing Medical University, Nanjing, China
| | - Man Wang
- Department of Geriatrics, Sir Run Run Hospital, Nanjing Medical University, Nanjing, China.,Key Laboratory for Aging & Disease, Nanjing Medical University, Nanjing, China
| | - Xiang Lu
- Department of Geriatrics, Sir Run Run Hospital, Nanjing Medical University, Nanjing, China.,Key Laboratory for Aging & Disease, Nanjing Medical University, Nanjing, China
| | - Wei Gao
- Department of Geriatrics, Sir Run Run Hospital, Nanjing Medical University, Nanjing, China.,Key Laboratory for Aging & Disease, Nanjing Medical University, Nanjing, China
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Gil S, Jacob Filho W, Shinjo SK, Ferriolli E, Busse AL, Avelino-Silva TJ, Longobardi I, de Oliveira Júnior GN, Swinton P, Gualano B, Roschel H. Muscle strength and muscle mass as predictors of hospital length of stay in patients with moderate to severe COVID-19: a prospective observational study. J Cachexia Sarcopenia Muscle 2021; 12:1871-1878. [PMID: 34523262 PMCID: PMC8661522 DOI: 10.1002/jcsm.12789] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 06/04/2021] [Accepted: 08/04/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Strength and muscle mass are predictors of relevant clinical outcomes in critically ill patients, but in hospitalized patients with COVID-19, it remains to be determined. In this prospective observational study, we investigated whether muscle strength or muscle mass are predictive of hospital length of stay (LOS) in patients with moderate to severe COVID-19 patients. METHODS We evaluated prospectively 196 patients at hospital admission for muscle mass and strength. Ten patients did not test positive for SARS-CoV-2 during hospitalization and were excluded from the analyses. RESULTS The sample comprised patients of both sexes (50% male) with a mean age (SD) of 59 (±15) years, body mass index of 29.5 (±6.9) kg/m2 . The prevalence of current smoking patients was 24.7%, and more prevalent coexisting conditions were hypertension (67.7%), obesity (40.9%), and type 2 diabetes (36.0%). Mean (SD) LOS was 8.6 days (7.7); 17.0% of the patients required intensive care; 3.8% used invasive mechanical ventilation; and 6.6% died during the hospitalization period. The crude hazard ratio (HR) for LOS was greatest for handgrip strength comparing the strongest versus other patients (1.47 [95% CI: 1.07-2.03; P = 0.019]). Evidence of an association between increased handgrip strength and shorter hospital stay was also identified when handgrip strength was standardized according to the sex-specific mean and standard deviation (1.23 [95% CI: 1.06-1.43; P = 0.007]). Mean LOS was shorter for the strongest patients (7.5 ± 6.1 days) versus others (9.2 ± 8.4 days). Evidence of associations were also present for vastus lateralis cross-sectional area. The crude HR identified shorter hospital stay for patients with greater sex-specific standardized values (1.20 [95% CI: 1.03-1.39; P = 0.016]). Evidence was also obtained associating longer hospital stays for patients with the lowest values for vastus lateralis cross-sectional area (0.63 [95% CI: 0.46-0.88; P = 0.006). Mean LOS for the patients with the lowest muscle cross-sectional area was longer (10.8 ± 8.8 days) versus others (7.7 ± 7.2 days). The magnitude of associations for handgrip strength and vastus lateralis cross-sectional area remained consistent and statistically significant after adjusting for other covariates. CONCLUSIONS Muscle strength and mass assessed upon hospital admission are predictors of LOS in patients with moderate to severe COVID-19, which stresses the value of muscle health in prognosis of this disease.
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Affiliation(s)
- Saulo Gil
- Applied Physiology & Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, São Paulo, SP, Brazil.,Laboratorio de Investigacao Medica em Envelhecimento (LIM-66), Servico de Geriatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Wilson Jacob Filho
- Laboratorio de Investigacao Medica em Envelhecimento (LIM-66), Servico de Geriatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Samuel Katsuyuki Shinjo
- Rheumatology Division, Hospital das Clinicas HCFMUSP, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Eduardo Ferriolli
- Laboratorio de Investigacao Medica em Envelhecimento (LIM-66), Servico de Geriatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil.,Division of Internal and Geriatric Medicine, Department of Internal Medicine - Ribeirão Preto Medical School, Universidade de Sao Paulo, Ribeirao Preto, Brazil
| | - Alexandre Leopold Busse
- Laboratorio de Investigacao Medica em Envelhecimento (LIM-66), Servico de Geriatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Thiago Junqueira Avelino-Silva
- Laboratorio de Investigacao Medica em Envelhecimento (LIM-66), Servico de Geriatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Igor Longobardi
- Applied Physiology & Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, São Paulo, SP, Brazil
| | - Gersiel Nascimento de Oliveira Júnior
- Applied Physiology & Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, São Paulo, SP, Brazil
| | - Paul Swinton
- School of Health Sciences, Robert Gordon University, Aberdeen, UK
| | - Bruno Gualano
- Applied Physiology & Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, São Paulo, SP, Brazil.,Rheumatology Division, Hospital das Clinicas HCFMUSP, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Hamilton Roschel
- Applied Physiology & Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, São Paulo, SP, Brazil.,Laboratorio de Investigacao Medica em Envelhecimento (LIM-66), Servico de Geriatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
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Katano S, Yano T, Ohori K, Kouzu H, Nagaoka R, Honma S, Shimomura K, Inoue T, Takamura Y, Ishigo T, Watanabe A, Koyama M, Nagano N, Fujito T, Nishikawa R, Ohwada W, Hashimoto A, Katayose M, Ishiai S, Miura T. Barthel Index Score Predicts Mortality in Elderly Heart Failure - A Goal of Comprehensive Cardiac Rehabilitation. Circ J 2021; 86:70-78. [PMID: 34544962 DOI: 10.1253/circj.cj-21-0584] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND A strategy to predict mortality in elderly heart failure (HF) patients has not been established.Methods and Results:We retrospectively enrolled 413 HF patients aged ≥65 years (mean age 78 years) who had received comprehensive cardiac rehabilitation (CR) during hospitalization. Basic activities of daily life were assessed before discharge using the Barthel index (BI). Of 413 HF patients, 116 (28%) died during a median follow-up period of 1.90 years (interquartile range 1.20-3.23 years). An adjusted dose-dependent association analysis showed that the hazard ratio (HR) of mortality increased in an almost linear manner as the BI score decreased, and that a BI score of 85 corresponded to an HR of 1.0. Kaplan-Meier survival curves showed that the survival rate was lower for patients with a low BI (<85) than for those with a high BI (≥85; 65% vs. 74%, respectively; P=0.007). In multivariate Cox regression analyses, low BI was independently associated with higher mortality after adjusting for predictors, including B-type natriuretic peptide. Inclusion of the BI into the adjusted model improved the accuracy of the prediction of mortality. CONCLUSIONS A BI score <85 at the time of discharge is associated with increased mortality independent of known prognostic markers, and achieving functional status with a BI score ≥85 by comprehensive CR during hospitalization may contribute to favorable outcomes in elderly HF patients.
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Affiliation(s)
- Satoshi Katano
- Division of Rehabilitation, Sapporo Medical University Hospital
| | - Toshiyuki Yano
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine
| | - Katsuhiko Ohori
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine.,Department of Cardiology, Hokkaido Cardiovascular Hospital
| | - Hidemichi Kouzu
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine
| | - Ryohei Nagaoka
- Division of Rehabilitation, Sapporo Medical University Hospital
| | - Suguru Honma
- Department of Rehabilitation, Sapporo Cardiovascular Hospital
| | | | | | - Yuhei Takamura
- Department of Rehabilitation, Hokkaido Ohno Memorial Hospital
| | - Tomoyuki Ishigo
- Division of Hospital Pharmacy, Sapporo Medical University Hospital
| | - Ayako Watanabe
- Division of Nursing, Sapporo Medical University Hospital
| | - Masayuki Koyama
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine.,Department of Public Health, Sapporo Medical University School of Medicine
| | - Nobutaka Nagano
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine
| | - Takefumi Fujito
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine
| | - Ryo Nishikawa
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine
| | - Wataru Ohwada
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine
| | - Akiyoshi Hashimoto
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine.,Division of Health Care Administration and Management, Sapporo Medical University School of Medicine
| | - Masaki Katayose
- Second Division of Physical Therapy, Sapporo Medical University School of Health Sciences
| | - Sumio Ishiai
- Department of Rehabilitation, Sapporo Medical University School of Medicine
| | - Tetsuji Miura
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine.,Department of Clinical Pharmacology, Faculty of Pharmaceutical Sciences, Hokkaido University of Science
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Konishi M, Akiyama E, Matsuzawa Y, Sato R, Kikuchi S, Nakahashi H, Maejima N, Iwahashi N, Kosuge M, Ebina T, Hibi K, Misumi T, von Haehling S, Anker SD, Tamura K, Kimura K. Prognostic impact of muscle and fat mass in patients with heart failure. J Cachexia Sarcopenia Muscle 2021; 12:568-576. [PMID: 33939328 PMCID: PMC8200420 DOI: 10.1002/jcsm.12702] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 01/16/2021] [Accepted: 03/15/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Cachexia, characterized by loss of muscle with or without loss of fat mass, is a poor prognostic factor in patients with heart failure (HF). However, there is limited investigation on the prognostic impact of muscle and fat mass separately in HF. We hypothesized that muscle and fat mass have different effects on the prognosis of HF. METHODS This was an observational cohort study of 418 patients (59% were men) admitted with a diagnosis of HF (71 ± 13 years [mean ± standard deviation]), with left ventricular ejection fraction (LVEF) of 39 ± 16%, including 31.3%, 14.8%, and 53.8% of patients with preserved LVEF (LVEF ≥ 50%), mid-range LVEF (40-50%), and reduced (<40%) LVEF, respectively. Dual-energy X-ray absorptiometry was performed with the patients in the stable state after decongestion therapy. RESULTS The mean body mass index of patients was 22.1 ± 4.6 kg/m2 , and the mean appendicular skeletal mass (ASM) index was 6.88 ± 1.23 kg/m2 in men and 5.59 ± 0.92 in women; 54.1% of the patients showed reduced muscle mass defined by the international cut-off value (7.0 kg/m2 for men and 5.4 for women). The mean fat mass was 20.4 ± 7.2% in men and 27.2 ± 8.6% in women. During a median follow-up of 37 months, 92 (22.0%) of 418 patients with HF died (1 and 3 year mortality: 8.4% and 17.3%, respectively). Lower values of both skeletal muscle and fat mass were independently associated with increased risk of mortality adjusted for age, sex, haemoglobin, New York Heart Association functional class, and height squared (hazard ratio with 95% confidence interval of 0.825 [0.747-0.908] per 1 kg increase of ASM, P < 0.001, and 0.954 [0.916-0.993] per 1 kg increase of fat mass, P = 0.018, respectively). CONCLUSIONS More than half of the patients with HF showed reduced muscle mass. Lower values of both muscle and fat mass were associated with higher mortality in HF.
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Affiliation(s)
- Masaaki Konishi
- Division of CardiologyYokohama City University Medical CenterYokohamaJapan
- Department of Medical Science and Cardiorenal MedicineYokohama City University Graduate School of MedicineYokohamaJapan
| | - Eiichi Akiyama
- Division of CardiologyYokohama City University Medical CenterYokohamaJapan
| | - Yasushi Matsuzawa
- Division of CardiologyYokohama City University Medical CenterYokohamaJapan
| | - Ryosuke Sato
- Division of CardiologyYokohama City University Medical CenterYokohamaJapan
| | - Shinnosuke Kikuchi
- Division of CardiologyYokohama City University Medical CenterYokohamaJapan
| | - Hidefumi Nakahashi
- Division of CardiologyYokohama City University Medical CenterYokohamaJapan
| | - Nobuhiko Maejima
- Division of CardiologyYokohama City University Medical CenterYokohamaJapan
| | - Noriaki Iwahashi
- Division of CardiologyYokohama City University Medical CenterYokohamaJapan
| | - Masami Kosuge
- Division of CardiologyYokohama City University Medical CenterYokohamaJapan
| | - Toshiaki Ebina
- Division of CardiologyYokohama City University Medical CenterYokohamaJapan
| | - Kiyoshi Hibi
- Division of CardiologyYokohama City University Medical CenterYokohamaJapan
| | - Toshihiro Misumi
- Department of BiostatisticsYokohama City University School of MedicineYokohamaJapan
| | - Stephan von Haehling
- Department of Cardiology and Pneumology; German Center for Cardiovascular Research (DZHK), partner site GöttingenUniversity of Göttingen Medical CenterGöttingenGermany
| | - Stefan D. Anker
- Department of Cardiology (CVK); and Berlin Institute of Health Center for Regenerative Therapies (BCRT); German Centre for Cardiovascular Research (DZHK) partner site BerlinCharité Universitätsmedizin BerlinBerlinGermany
| | - Kouichi Tamura
- Department of Medical Science and Cardiorenal MedicineYokohama City University Graduate School of MedicineYokohamaJapan
| | - Kazuo Kimura
- Division of CardiologyYokohama City University Medical CenterYokohamaJapan
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