Prognostic impact of muscle and fat mass in patients with heart failure

Journal of Cachexia, Sarcopenia and Muscle

Stefan D. Anker¹  Kazuo Kimura²  Toshihiro Misumi³  Kouichi Tamura⁴  Stephan vonHaehling⁵  Hidefumi Nakahashi⁶  Masaaki Konishi⁶  Eiichi Akiyama⁶  Noriaki Iwahashi⁶  Yasushi Matsuzawa⁶  Ryosuke Sato⁶  Masami Kosuge⁶  Kiyoshi Hibi⁶  Nobuhiko Maejima⁶  Shinnosuke Kikuchi⁶  Toshiaki Ebina⁶ 

[1] German Center for Cardiovascular Research (DZHK), partner site Göttingen University of Göttingen Medical Center Göttingen Germany;and Berlin Institute of Health Center for Regenerative Therapies (BCRT);Department of Biostatistics Yokohama City University School of Medicine Yokohama Japan;Department of Cardiology (CVK);Department of Cardiology and Pneumology;Division of Cardiology Yokohama City University Medical Center Yokohama Japan;

关键词: Sarcopenia;    Cachexia;    Frailty;    Skeletal muscle;    Fat mass;    Heart failure;   

DOI  :  10.1002/jcsm.12702

来源: DOAJ

【 摘 要 】

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.

【 授权许可】

Unknown