Prevalence of sarcopenia in heart failure: A systematic review

Lakshman Chandrashekhar Iyer, K Vaishali, Abraham Samuel Babu, Lakshman Chandrashekhar Iyer, K Vaishali, Abraham Samuel Babu

Abstract

Objective: Heart Failure (HF) is emerging as a crucial factor promoting muscle wasting and dysfunction contributing to sarcopenia. This modulates disease severity and reduces exercise capacity and leading to poorer outcomes. Therefore, we aimed to systematically investigate the overall prevalence of sarcopenia in HF.

Methods: An electronic search was carried out in selected databases until 21st January, 2021. Data was pooled from the included articles and represented as pooled prevalence of sarcopenia. Subgroup analysis was undertaken between methods of diagnosis of sarcopenia, gender, ejection fraction, median time point and geographical region.

Results: Amongst 32,643 citations imported from selected databases, 12 articles were included in final analysis. Analysis for prevalence of sarcopenia was 34%, with prevalence rates ranging from 10.1% to 68%. Subgroup analysis revealed strong associations between Dual-energy X-ray Absorptiometry (DXA) and Asian Working Group for Sarcopenia (AWGS) (chi square = 3.24; p < 0.001), with a good level of agreement (kappa = 0.76 [95% CI: 0.70-0.82]; p < 0.001). Gender wise analysis revealed higher prevalence of sarcopenia among males (66%) than females (34%).

Conclusion: Sarcopenia is highly prevalent among those with HF (irrespective of type of HF) and is more commonly seen in males compared to females.

Keywords: Heart failure; Muscle wasting; Prevalence; Sarcopenia.

Copyright © 2022 Cardiological Society of India. Published by Elsevier, a division of RELX India, Pvt. Ltd. All rights reserved.

Figures

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Fig. 1
PRISMA flow chart - Study selection process.

References

    1. Long L., Mordi I.R., Bridges C., et al. Exercise-based cardiac rehabilitation for adults with heart failure. Cochrane Database Syst Rev. 2019;1:CD003331.
    1. Savarese G., Lund L.H. Global public health burden of heart failure. Card Fail Rev. 2017;3(1):7–11.
    1. Fülster S., Tacke M., Sandek A., et al. Muscle wasting in patients with chronic heart failure: results from the studies investigating co-morbidities aggravating heart failure (SICA-HF) Eur Heart J. 2013;34(7):512–519.
    1. Cruz-Jentoft A.J., Bahat G., Bauer J., et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48(1):16–31.
    1. Tsuchida K., Fujihara Y., Hiroki J., et al. Significance of sarcopenia evaluation in acute decompensated heart failure: skeletal muscle mass index versus fat-free mass index. Int Heart J. 2018;59(1):143–148.
    1. Ponikowski P., Voors A.A., Anker S.D., et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC)Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J. 2016;37(27):2129–2200.
    1. Page M.J., McKenzie J.E., Bossuyt P.M., et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71. doi: 10.1136/bmj.n71.
    1. Cruz-Jentoft A.J., Baeyens J.P., Bauer J.M., et al. Sarcopenia: European consensus on definition and diagnosis: report of the European working group on sarcopenia in older People. Age Ageing. 2010;39(4):412–423.
    1. Chen L.-K., Liu L.-K., Woo J., et al. Sarcopenia in Asia: consensus report of the asian working group for sarcopenia. J Am Med Dir Assoc. 2014;15(2):95–101.
    1. Modesti P.A., Reboldi G., Cappuccio F.P., et al. Panethnic differences in blood pressure in Europe: a systematic review and meta-analysis. PLoS One. 2016;11(1)
    1. Guglielmi G., Ponti F., Agostini M., et al. The role of DXA in sarcopenia. Aging Clin Exp Res. 2016;28(6):1047–1060.
    1. Hajahmadi M., Shemshadi S., Khalilipur E., et al. Muscle wasting in young patients with dilated cardiomyopathy: muscle wasting in young patients with dilated cardiomyopathy. J Cachexia Sarcopenia Muscle. 2017;8(4):542–548.
    1. Tacke M., Ebner N., Boschmann M., et al. Resting energy expenditure and the effects of muscle wasting in patients with chronic heart failure: results from the Studies Investigating Comorbidities Aggravating Heart Failure (SICA-HF) J Am Med Dir Assoc. 2013;14(11):837–841.
    1. Steinbeck L., Ebner N., Valentova M., et al. Detection of muscle wasting in patients with chronic heart failure using C-terminal agrin fragment: results from the Studies Investigating Co-morbidities Aggravating Heart Failure (SICA-HF): detection of muscle wasting in patients with CHF using CAF. Eur J Heart Fail. 2015;17(12):1283–1293.
    1. Bekfani T., Pellicori P., Morris D.A., et al. Sarcopenia in patients with heart failure with preserved ejection fraction: impact on muscle strength, exercise capacity and quality of life. Int J Cardiol. 2016;222:41–46.
    1. Saitoh M., Dos Santos M.R., Ebner N., et al. Nutritional status and its effects on muscle wasting in patients with chronic heart failure: insights from Studies Investigating Co-morbidities Aggravating Heart Failure. Wien Klin Wochenschr. 2016;128(Suppl 7):497–504.
    1. Dos Santos M.R., Saitoh M., Ebner N., et al. Sarcopenia and endothelial function in patients with chronic heart failure: results from the Studies Investigating Comorbidities Aggravating heart failure (SICA-HF) J Am Med Dir Assoc. 2017;18(3):240–245.
    1. Emami A., Saitoh M., Valentova M., et al. Comparison of sarcopenia and cachexia in men with chronic heart failure: results from the Studies Investigating Co-morbidities Aggravating Heart Failure (SICA-HF): comparison of sarcopenia and cachexia in men with chronic HF. Eur J Heart Fail. 2018;20(11):1580–1587.
    1. von Haehling S., Garfias Macedo T., Valentova M., et al. Muscle wasting as an independent predictor of survival in patients with chronic heart failure. J Cachexia Sarcopenia Muscle. 2020;11(5):1242–1249.
    1. Fonseca G.W.P.D., Dos Santos M.R., de Souza F.R., et al. Discriminating sarcopenia in overweight/obese male patients with heart failure: the influence of body mass index. ESC Heart Fail. 2020;7(1):84–91.
    1. Nozaki Y., Yamaji M., Nishiguchi S., et al. Sarcopenia predicts adverse outcomes in an elderly outpatient population with New York heart association class II–IV heart failure: a prospective cohort study. Aging Med Healthc. 2019;10(2):53–61.
    1. Zhao W., Lu M., Wang X., Guo Y. The role of sarcopenia questionnaires in hospitalized patients with chronic heart failure. Aging Clin Exp Res. 2021;33(2):339–344.
    1. Fonseca GWP da, Santos M.R.D., Souza FR de, et al. Sympatho-vagal imbalance is associated with sarcopenia in male patients with heart failure. Arq Bras Cardiol. 2019;112(6):739–746.
    1. Canteri A.L., Gusmon L.B., Zanini A.C., et al. Sarcopenia in heart failure with reduced ejection fraction. Am J Cardiovasc Dis. 2019;9(6):116–126.
    1. Narumi T., Watanabe T., Kadowaki S., et al. Sarcopenia evaluated by fat-free mass index is an important prognostic factor in patients with chronic heart failure. Eur J Intern Med. 2015;26(2):118–122.
    1. Onoue Y., Izumiya Y., Hanatani S., et al. A simple sarcopenia screening test predicts future adverse events in patients with heart failure. Int J Cardiol. 2016;215:301–306.
    1. Kono Y., Izawa H., Aoyagi Y., et al. The difference in determinant factor of six-minute walking distance between sarcopenic and non-sarcopenic elderly patients with heart failure. J Cardiol. 2020;75(1):42–46.
    1. Matsumura K., Teranaka W., Matsumoto H., et al. Loss of skeletal muscle mass predicts cardiac death in heart failure with a preserved ejection fraction but not heart failure with a reduced ejection fraction. ESC Heart Fail. 2020;7(6):4100–4107.
    1. Zhang Y., Zhang J., Ni W., et al. Sarcopenia in heart failure: a systematic review and meta-analysis. ESC Heart Fail. 2021;8(2):1007–1017.
    1. Mohanty L., Sahoo D. Prevalence and risk factors of sarcopenia: a study in a tertiary care centre. Int J Adv Med. 2016;3(2):364–367.
    1. Pacifico J., Geerlings M.A.J., Reijnierse E.M., et al. Prevalence of sarcopenia as a comorbid disease: a systematic review and meta-analysis. Exp Gerontol. 2020;131(110801)
    1. Morishita S. Prevalence of sarcopenia in cancer patients: review and future directions. Int J Phys Med Rehabil. 2016;4(3) doi: 10.4172/2329-9096.1000342.
    1. Eisenberg E., Di Palo K.E., Piña I.L. Sex differences in heart failure. Clin Cardiol. 2018;41(2):211–216.
    1. Yang L., Yao X., Shen J., et al. Comparison of revised EWGSOP criteria and four other diagnostic criteria of sarcopenia in Chinese community-dwelling elderly residents. Exp Gerontol. 2020;130 110798.
    1. Boo S.-H., Joo M.C., Lee J.M., et al. Association between skeletal muscle mass and cardiorespiratory fitness in community-dwelling elderly men. Aging Clin Exp Res. 2018;31(1):49–57.
    1. Nichols S., O'Doherty A.F., Taylor C., et al. Low skeletal muscle mass is associated with low aerobic capacity and increased mortality risk in patients with coronary heart disease - a CARE CR study. Clin Physiol Funct Imag. 2019;39(1):93–102.
    1. Del Buono M.G., Arena R., Borlaug B.A., et al. Exercise intolerance in patients with heart failure: JACC state-of-the-art review. J Am Coll Cardiol. 2019;73(17):2209–2225.
    1. Seiler M., Bowen T.S., Rolim N., et al. Skeletal muscle alterations are exacerbated in heart failure with reduced compared with preserved ejection fraction: mediated by circulating cytokines?: mediated by circulating cytokines? Circ Heart Fail. 2016;9(9) doi: 10.1161/CIRCHEARTFAILURE.116.003027.
    1. Adams V., Linke A., Winzer E. Skeletal muscle alterations in HFrEF vs. HFpEF. Curr Heart Fail Rep. 2017;14(6):489–497.
    1. Yang L., Yao X., Shen J., et al. Comparison of revised EWGSOP criteria and four other diagnostic criteria of sarcopenia in Chinese community-dwelling elderly residents. Exp Gerontol. 2020;130(110798) doi: 10.1016/j.exger.2019.110798.
    1. Smith L., Jacob L., Barnett Y., et al. Association between food insecurity and sarcopenia among adults aged ≥65 years in low- and middle-income countries. Nutrients. 2021;13(6):1879. doi: 10.3390/nu13061879.

Source: PubMed

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