Association Between Sarcopenia and Heart Failure Phenotypes In Older Adults

Backgrounds Sarcopenia is increasingly recognized as an important comorbidity in older adults with chronic heart failure (HF), contributing to functional decline and adverse clinical outcomes. However, differences in sarcopenia burden across HF phenotypes remain insufficiently explored. Methods This cross-sectional study included 140 participants aged 60 years or older, comprising 70 patients with chronic heart failure and 70 participants without heart failure, recruited from a tertiary hospital in Indonesia. HF was diagnosed according to the 2023 guideline of the Indonesian Heart Association (PERKI) and classified as heart failure with reduced ejection fraction (HFrEF), mildly reduced ejection fraction (HFmrEF), and preserved ejection fraction (HFpEF). Sarcopenia was defined using the Asian Working Group for Sarcopenia 2019 criteria. Multivariate logistic regression was performed to identify factors independently associated with sarcopenia. Results Sarcopenia was more prevalent in participants with chronic HF than in those without HF (58.6% vs. 21.4%; p < 0.001). Chronic HF was independently associated with sarcopenia (adjusted odds ratio [OR], 6.1; 95% confidence interval [CI], 2.70–13.73; p < 0.001). Among HF phenotypes, the highest prevalence of sarcopenia was observed in HFpEF (76.2%; p = 0.041). EF subtype was not significantly associated with sarcopenia severity (p = 0.575). Age 70 years or older and non-obese status were also independently associated with sarcopenia. Conclusions Sarcopenia was highly prevalent in older adults with chronic HF, particularly in those with HFpEF. Routine sarcopenia screening may help support earlier multidisciplinary management in this population.