Comparison of sarcopenia and cachexia in men with chronic heart failure: Results from the Studies Investigating Co-morbidities Aggravating Heart Failure (SICA-HF)

von Amir Emami
Dissertation
Datum der mündl. Prüfung:2021-05-18
Erschienen:2021-05-05
Betreuer:Prof. Dr. Stephan von Haehling
Gutachter:Prof. Dr. Christoph Herrmann-Lingen
Gutachter:Prof. Dr. Martin Oppermann
Zum Verlinken/Zitieren: http://dx.doi.org/10.53846/goediss-8586

 

 

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Englisch

Muscle wasting is acknowledged as a co-morbidity of heart failure (HF) and is associated with poor prognosis (ESC 2016). Cardiac cachexia is known to cause reduced functional capacity, more frequent hospitalization, and decreased survival rate (ESC 2016). This study aimed to compare the impacts of sarcopenia, cachexia, and their overlap on exercise tolerance and quality of life (QOL) in chronic HF patients.  We included retrospectively 207 outpatients with chronic HF into a cross-sectional study based on the Studies Investigating Co-morbidities Aggravating Heart Failure (SICA-HF) database. Body composition was measured using dual-energy X-ray absorptiometry (DXA). Functional performance was assessed with peak oxygen uptake (peakVO2), 6-minute-walk-test (6MWT), and short physical performance battery (SPPB) test. The handgrip and quadriceps strength were measured using isokinetic dynamometry. Quality of life (QOL) was evaluated using the EuroQol-5-Dimension (EQ-5D) questionnaire to calculate the EQ-5D index score.   Sarcopenia was present in 21.3% of our HF patients. In this context, 14.5% fulfilled sarcopenia's definition without associated cachexia (sarcopenic HF group). 12.1% presented with cachexia without concomitant sarcopenia (cachectic HF group). Furthermore, 6.8% of patients demonstrated the characteristics of both cachexia and sarcopenia (overlap group).  The lowest results for functional capacity, muscle strength, and QOL were observed in patients with sarcopenia. Both of the overlap and sarcopenic HF groups showed the lowest values for muscle strength, 6MWT distance, peakVO2, SPPB score, and EQ-5D index score vs. control group (all p < 0.05). The overlap group showed the weakest quadriceps strength vs. all other groups (p < 0.05). We found significantly lower results for peakVO2 and quadriceps strength among the cachectic HF group vs. the control group, but this effect was not constant in other functional tests. The cachectic HF could not demonstrate significantly lower QOL indices.  Male HF patients with sarcopenia seem to have significantly lower functional performance and QOL. These effects remain constant with/or without associated cachexia. Our study highlights the importance of early screening for sarcopenia among HF patients. In this regard, BMI cannot be a reliable representative of patients' body composition.
Keywords: Heart failure; Muscle wasting; Sarcopenia; Cachexia
 
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