Application value of two-dimensional ultrasound and shear-wave elastography parameters in evaluating sarcopenia with essential hypertension

Background: Patients with essential hypertension have a high risk of muscle mass and strength decline. Ultrasound is a promising method for assessing sarcopenia. This study aimed to analyze the correlation between ultrasound and shear-wave elastography (SWE) features, and muscle mass, muscle strength, and physical performance, and to assess the clinical applicability of ultrasound in the diagnosis of sarcopenia in patients with essential hypertension. Methods: In total, 134 patients with essential hypertension were enrolled in this cross-sectional study. The appendicular skeletal muscle mass index (ASMI), handgrip strength, and 6-meter walking speed of all the patients were measured. The patients were classified into the sarcopenia group and the non-sarcopenia group. The ultrasound-derived muscle thickness (MT), cross-sectional area (CSA), and SWE of the rectus femoris muscle (RFM) were measured in both the relaxed and contracted states. In addition, ultrasound features, such as the muscle fascicle length (Fl), pennation angle (PA), MT, and SWE of the gastrocnemius medialis muscle (GMM), were measured in the relaxed state. Correlations between the clinical indicators, and the ultrasound and SWE features were analyzed. The clinical indicators, and the ultrasound and SWE features were then compared between the sarcopenia and non-sarcopenia groups to determine the independent predictors. Based on these predictors, diagnostic models were established by logistic regression analysis. Results: Both the ASMI and grip strength were positively correlated with the ultrasound-derived MT and CSA of the RFM in the relaxed and contracted states, and positively correlated with the MT, Fl, PA, and SWE of the GMM in the relaxed state (all P<0.05). The 6-meter walking speed was positively correlated with the ultrasound-derived MT and CSA of the RFM in the relaxed and contracted states, and positively correlated with the Fl and SWE of the GMM in the relaxed state (all P<0.05). Compared with the non-sarcopenia patients, the sarcopenia patients had a decrease in the ultrasound-derived MT and CSA of the RFM in the relaxed and contracted states, and the MT, Fl and SWE of the GMM in the relaxed state (all P<0.05). Based on these results, the cut-off value of the prediction model was 0.443, and it had a diagnostic sensitivity of 84.5% and a specificity of 90.8%. Conclusions: Two-dimensional ultrasound combined with the SWE model can be used to diagnose sarcopenia in patients with essential hypertension. The model has high sensitivity and specificity, and can more accurately detect sarcopenia in patients with essential hypertension.