Muscle wasting as an independent predictor of survival in patients with chronic heart failure.

von Haehling, Stephan; Garfias Macedo, Tania; Valentova, Miroslava; Anker, Markus S; Ebner, Nicole; Bekfani, Tarek; Haarmann, Helge; Schefold, Joerg C.; Lainscak, Mitja; Cleland, John G F; Doehner, Wolfram; Hasenfuss, Gerd; Anker, Stefan D (2020). Muscle wasting as an independent predictor of survival in patients with chronic heart failure. Journal of cachexia, sarcopenia and muscle, 11(5), pp. 1242-1249. Wiley 10.1002/jcsm.12603

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BACKGROUND

Skeletal muscle wasting is an extremely common feature in patients with heart failure, affecting approximately 20% of ambulatory patients with even higher values during acute decompensation. Its occurrence is associated with reduced exercise capacity, muscle strength, and quality of life. We sought to investigate if the presence of muscle wasting carries prognostic information.

METHODS

Two hundred sixty-eight ambulatory patients with heart failure (age 67.1 ± 10.9 years, New York Heart Association class 2.3 ± 0.6, left ventricular ejection fraction 39 ± 13.3%, and 21% female) were prospectively enrolled as part of the Studies Investigating Co-morbidities Aggravating Heart Failure. Muscle wasting as assessed using dual-energy X-ray absorptiometry was present in 47 patients (17.5%).

RESULTS

During a mean follow-up of 67.2 ± 28.02 months, 95 patients (35.4%) died from any cause. After adjusting for age, New York Heart Association class, left ventricular ejection fraction, creatinine, N-terminal pro-B-type natriuretic peptide, and iron deficiency, muscle wasting remained an independent predictor of death (hazard ratio 1.80, 95% confidence interval 1.01-3.19, P = 0.04). This effect was more pronounced in patients with heart failure with reduced than in heart failure with preserved ejection fraction.

CONCLUSIONS

Muscle wasting is an independent predictor of death in ambulatory patients with heart failure. Clinical trials are needed to identify treatment approaches to this co-morbidity.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic of Intensive Care

UniBE Contributor:

Schefold, Jörg Christian

Subjects:

600 Technology > 610 Medicine & health

ISSN:

2190-5991

Publisher:

Wiley

Language:

English

Submitter:

Mirella Aeberhard

Date Deposited:

13 Aug 2020 10:03

Last Modified:

18 Oct 2020 01:34

Publisher DOI:

10.1002/jcsm.12603

PubMed ID:

32767518

Uncontrolled Keywords:

Cachexia Heart failure Sarcopenia Survival Wasting

BORIS DOI:

10.7892/boris.145799

URI:

https://boris.unibe.ch/id/eprint/145799

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