Abstract 15517: Sarcopenia in Heart Failure Patients Without Dementia is Associated With Local Brain Atrophy and Predicts Poor Prognosis

Abstract

Background: Sarcopenia is age-related loss of skeletal muscle volume and strength. Aged Heart failure (HF) patients without dementia may have potential risk of cognitive impairment (CI) that attenuates the effect of treatment. Patients with CI have severe brain atrophy in parahippocampal gyrus (PHG). However, it is not clear whether sarcopenia is associated with local brain atrophy and predicts prognosis. Hypothesis: Sarcopenia in HF patients without dementia is associated with local brain atrophy of PHG, a potential risk of CI, and predicts prognosis. Methods: Fifty-four HF patients (age 78+/-8 years, NYHA class II, EF47+/-18 %) were enrolled. We excluded patients with dementia using mini-mental state examination. We took 3D-T1 weighted sagittal images of whole brain using 1.5T magnetic resonance imaging. Image analysis was performed to evaluate the severity of local brain atrophy of gray matter using 2mm voxel-based morphometry by the statistical parametric mapping software. The Z-score value was calculated to evaluate the severity of atrophy in PHG. The cross-sectional area of the erector spinae muscles (CSA), an index of sarcopenia, were measured at the 12th thoracic vertebra using computed tomography. Results: Patients were divided into sarcopenia HF group (n=27) and Non-sarcopenia HF group (n=27) according to median of CSA. The severity of total brain atrophy was similar between sarcopenia HF group (8.1 +/-3.8%) and Non-sarcopenia HF group (8.9+/-3.5%). However, as shown in the representative cases (Figure A), the Z-score value in PHG (pink circle), reflecting the severity of atrophy, was prominent in sarcopenia HF group (1.57+/-0.80) (white arrows) in comparison with Non-sarcopenia HF group (0.94+/-0.63, P=0.002). Although age, gender, BNP and hemodynamic factors were similar between groups, sarcopenia HF group had a lower survival rate (Figure B). Conclusions: HF patients with sarcopenia without dementia have potential risk of CI and poor prognosis.