Cargando…

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

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...

Descripción completa

Detalles Bibliográficos
Autores principales: 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.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7567155/
https://www.ncbi.nlm.nih.gov/pubmed/32767518
http://dx.doi.org/10.1002/jcsm.12603
_version_ 1783596266467360768
author 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.
author_facet 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.
author_sort von Haehling, Stephan
collection PubMed
description 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.
format Online
Article
Text
id pubmed-7567155
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher John Wiley and Sons Inc.
record_format MEDLINE/PubMed
spelling pubmed-75671552020-10-21 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. J Cachexia Sarcopenia Muscle Original Articles 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. John Wiley and Sons Inc. 2020-08-06 2020-10 /pmc/articles/PMC7567155/ /pubmed/32767518 http://dx.doi.org/10.1002/jcsm.12603 Text en © 2020 The Authors. Journal of Cachexia, Sarcopenia and Muscle published by John Wiley & Sons Ltd on behalf of Society on Sarcopenia, Cachexia and Wasting Disorders This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Articles
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.
Muscle wasting as an independent predictor of survival in patients with chronic heart failure
title Muscle wasting as an independent predictor of survival in patients with chronic heart failure
title_full Muscle wasting as an independent predictor of survival in patients with chronic heart failure
title_fullStr Muscle wasting as an independent predictor of survival in patients with chronic heart failure
title_full_unstemmed Muscle wasting as an independent predictor of survival in patients with chronic heart failure
title_short Muscle wasting as an independent predictor of survival in patients with chronic heart failure
title_sort muscle wasting as an independent predictor of survival in patients with chronic heart failure
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7567155/
https://www.ncbi.nlm.nih.gov/pubmed/32767518
http://dx.doi.org/10.1002/jcsm.12603
work_keys_str_mv AT vonhaehlingstephan musclewastingasanindependentpredictorofsurvivalinpatientswithchronicheartfailure
AT garfiasmacedotania musclewastingasanindependentpredictorofsurvivalinpatientswithchronicheartfailure
AT valentovamiroslava musclewastingasanindependentpredictorofsurvivalinpatientswithchronicheartfailure
AT ankermarkuss musclewastingasanindependentpredictorofsurvivalinpatientswithchronicheartfailure
AT ebnernicole musclewastingasanindependentpredictorofsurvivalinpatientswithchronicheartfailure
AT bekfanitarek musclewastingasanindependentpredictorofsurvivalinpatientswithchronicheartfailure
AT haarmannhelge musclewastingasanindependentpredictorofsurvivalinpatientswithchronicheartfailure
AT schefoldjoergc musclewastingasanindependentpredictorofsurvivalinpatientswithchronicheartfailure
AT lainscakmitja musclewastingasanindependentpredictorofsurvivalinpatientswithchronicheartfailure
AT clelandjohngf musclewastingasanindependentpredictorofsurvivalinpatientswithchronicheartfailure
AT doehnerwolfram musclewastingasanindependentpredictorofsurvivalinpatientswithchronicheartfailure
AT hasenfussgerd musclewastingasanindependentpredictorofsurvivalinpatientswithchronicheartfailure
AT ankerstefand musclewastingasanindependentpredictorofsurvivalinpatientswithchronicheartfailure