Screening And Correlation Study Of Sarcopenia In Elderly Patients With Chronic Heart Failure

Objective:In recent years,sarcopenia has gradually become an important comorbidity of chronic heart failure(CHF),and with the increase of age,the incidence of increasing trend,the interaction between the two,and ultimately lead to poor prognosis.In this study,we used SARC-F,SARC-F+EBM,SARC-CALF scales to screen the elderly patients with CHF for sarcopenia,compared the screening value of the three questionnaires for the diagnosis of sarcopenia,and analyzed the related factors of elderly patients with CHF complicated with sarcopenia,so as to better guide the clinical treatment and prognosis of elderly patients with CHF。Methods:109 elderly patients(≥60 years old)with CHF,who were admitted to the Department of Cardiology,Shanxi medical university third hospital,were selected for body composition analysis.Based on the diagnostic criteria for sarcopenia updated by the Asian Sarcopenia Working Group in 2019(AWGS 2019),the subjects were divided into sarcopenia group(n=41)and non-sarcopenia group(n=68).SARC-F,SARC-CALF and SARC-F+EBM scales were used to screen all subjects for sarcopenia,and AWGS 2019 was used as the standard to compare the screening accuracy of the three questionnaires.The general information and main medical history of all subjects were collected,including name,gender,age,height,weight,body mass index(BMI),smoking history,drinking history,hypertension history,coronary heart disease history,calf circumference(CC),grip strength,walking speed,limb skeletal muscle index(ASMI);All patients were assessed with MNA-SF.Collect relevant biochemical indicators,including hemoglobin(Hb),red blood cell distribution width(RNW),triglyceride(TG),total cholesterol(TC),albumin(ALB),B-type natriuretic peptide(BNP),soluble growth stimulatory expressed gene 2 protein(ST2);Left ventricular ejection fraction(LVEF)as indicated by echocardiography was recorded.The general data,main medical history,biochemical indexes and echocardiography results of the two groups were statistically analyzed to further analyze the related factors of senile chronic heart failure complicated with sarcopema.Results:(1)Using AWGS 2019 as diagnostic criteria,the prevalence of sarcopenia was 37.6%;The prevalence of SARC-F was 28.4%.The prevalence of SARC-F+EBM was 71.6%.The prevalence of SARC-CALF was 51.4%.(2)In all subjects,using AWGS 2019 as the standard,the sensitivity of SARC-F was 58.5%and the specificity was 88.2%;The sensitivity and specificity of SARC-F+EBM were 73.2%and 92.6%respectively.SARC-CALF had a sensitivity of 73.2%and a specificity of 85%.(3)Compared with non-sarcopenia group,the level of ALB in sarcopenia group was significantly lower(P<0.05),and the age,body weight,BMI,nutritional status,LVEF,walking speed,grip strength,CC,ASMI,TG,RNW in sarcopenia group were significantly lower(P<0.001).(4)Age,body weight,BMI,LVEF,ASMI and 6-meter walking speed were independent risk factors for senile CHF complicated with sarcopenia.Conclusion:In this study,SARC-F,SARC-F+EBM and SARC-CALF were used to screen for sarcopenia in hospitalized elderly patients with CHF.Comprehensive comparison showed that SARC-F+EBM had the highest sensitivity(73.2%)and the strongest specificity(92.6%),which could be used as a screening tool for sarcopenia in hospitalized elderly patients with CHF.Further statistical analysis showed that age,body weight,BMI,LVEF,ASMI,6m walking speed were independent factors of senile CHF complicated with sarcopenia.