Effect of sarcopenia on skeletal muscle and cardiac function in elderly patients with chronic heart failure

Abstract

Objective To investigate the effect of sarcopenia on the skeletal muscle and cardiac function in elderly patients with chronic heart failure (CHF). Methods Sixty patients with CHF and sarcopenia and 60 sex and age-matched CHF patients without sarcopenia were enrolled from September 2014 to December 2015. The skeletal mass was evaluated by fat-free mass index (FFMI) and muscle function was evaluated by gait speed (GS), hand strength (HS) and the simple physical performance battery (SPPB). The cardiac function was accessed by a 6-min walk distance (6-MWD) and left ventricular ejection fraction (LVEF). Furthermore, the serum inflammation cytokines IL-6, TNF-α, and skeletal muscle biomarker C1q were measured. Results The CHF patients with sarcopenia had lower values for skeletal muscle mass: FFMI [(17.68±0.74) vs. (18.34±0.54)kg/m2, F=33.696, P<0.05] and lower muscle function: HS [(17.26±4.20) vs. (28.85±6.43)kg, F=136.54, P<0.05], GS [(0.65±0.11) vs. (0.90±0.10)m/s, F=-12.922, P<0.05], SPPB [(6.45±2.07) vs. (7.65±1.76), t=-3.452, P<0.05]. And the cardiac function decreased significantly in patients with sarcopenia: 6-MWD [(253.76±72.62) vs. (340.91±55.78)m, F=54.350, P<0.05], LVEF [(39.12±7.02)vs. (43.83±5.81)%, t=16.060, P<0.05]. Serum IL-6/TNF-α/C1q levels were significantly elevated: IL-6[(14.12±1.40) vs. (13.46±1.06) ng/L, F=8.513, P<0.05], TNF-α [(443.43±28.06) vs. (299.37±21.53)ng/L, t=31.556, P<0.05], C1q[(578.92±23.63) vs. (504.11±41.77)ng/L, F=145.78, P<0.05]. Conclusion The CHF patients with sarcopenia present less skeletal muscle mass, poorer skeletal function and reduced cardiac function, and higher inflammation levels. Key words: Heart failure; Aged; Complement C1q; Sarcopenia