Key result
Sarcopenia, defined by low psoas muscle area, was associated with a 4.5-fold increased risk of 1-year all-cause mortality in patients with heart failure (HR 4.5; 95% CI 1.784-11.765; p=0.0016).
Why the study?
Heart failure symptoms are more common with low skeletal muscle mass, but estimating muscle mass can be unreliable, and whether sarcopenia is associated with survival after an acute hospitalization was unknown.
Does sarcopenia (low psoas muscle area) predict all-cause mortality in patients with chronic heart failure after an acute hospitalization?
Cohort (n=160)
Does sarcopenia (low psoas muscle area) predict all-cause mortality in patients with chronic heart failure after an acute hospitalization?
Hazard Ratio: 4.5 (95% CI 1.784–11.765)
p-value: p=0.0016
Low skeletal muscle mass, estimated by psoas muscle area on CT, is a strong independent predictor of 1-year mortality in patients hospitalized for heart failure.
Sarcopenia assessment may refine post-discharge HF mortality risk stratification; leaves open whether muscle-targeted interventions improve survival.
BACKGROUND: Heart failure (HF) is a syndrome associated with exercise intolerance, and its symptoms are more common in patients with low skeletal muscle mass (SMM). Estimation of muscle mass can be cumbersome and unreliable, particularly in patients with varying body weight. The psoas muscle area (PMA) can be used as a surrogate of sarcopenia and has been associated with poor outcomes in other populations. OBJECTIVES: The aim of this study was to assess if sarcopenia is associated with the survival of patients with HF after an acute hospitalization. METHOD: We retrospectively studied a cohort of 160 patients with HF who had abdominopelvic computed tomography during an acute hospitalization. We obtained standardized measurements of their PMA and defined sarcopenia as the lowest gender-based tertile of the said area. The patients were followed until death or discontinuation of care. We used Kaplan-Meier estimates and Cox regression analysis to assess the relationship between sarcopenia and all-cause mortality. RESULTS: We found that the 52 patients with sarcopenia had 4.5 times the risk of all-cause mortality at 1 year compared to the rest of the cohort (CI 1.784-11.765; p = 0.0016) after adjusting for significant covariates. Stratification by age and sex revealed that this association could be limited to males and patients < 75 years old. CONCLUSION: The PMA, used as a surrogate of low SMM, is independently associated with an increased risk of late mortality after an acute hospitalization in patients with HF.
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López et al. (2019) conducted a cohort in Heart failure after an acute hospitalization (n=160). Sarcopenia (low psoas muscle area) vs. Rest of the cohort (higher psoas muscle area) was evaluated on All-cause mortality at 1 year (HR 4.5, 95% CI 1.784-11.765, p=0.0016). Sarcopenia, defined by low psoas muscle area, was associated with a 4.5-fold increased risk of 1-year all-cause mortality in patients with heart failure (HR 4.5; 95% CI 1.784-11.765; p=0.0016).
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