Patient-Reported Health Status in Relation to Change in Skeletal Muscle Mass and Function during Left Ventricular Assist Device Support

Abstract

Purpose Patients with heart failure (HF) frequently experience loss of skeletal muscle mass and strength. It is unknown if loss of muscle mass and/or strength in patients with HF is associated with quality of life (QoL) reductions. Understanding the relationship between loss of muscle mass, strength and HF-specific patient reported health status is essential in defining the clinical importance of skeletal muscle wasting. Methods We retrospectively analyzed data collected prospectively between 5/2016-3/2020 from patients with advanced systolic HF requiring left ventricular assist device (LVAD) support. There were 3 visits: 0 (baseline), 3 and 6 months of LVAD support. Each visit included whole-body dual X-ray absorptiometry (DXA) to calculate appendicular lean mass (ALM), a hydraulic hand dynamometer for handgrip strength, and a Kansas City Cardiomyopathy Questionnaire (KCCQ). KCCQ is a HF-specfic measure of patient-reported health status, symptoms, physical/social functioning and QoL, with summary scores ranging 0-100 (higher indicates better health status) and domain-specific subscores. Linear mixed effects models were used to evaluate relationships between ALM, handgrip strength and KCCQ scores over time, adjusted for potential confounders. Results The cohort was 90% (36/40) male with mean age 57 ±12 years. The median HF duration was 50 months. From baseline to 6 months, there was a significant increase in KCCQ scores (baseline: 46.6 ±19.0, n=40; 3 months: 65.4 ±18.3, n=35, p Conclusion Among patients with advanced HF, skeletal muscle mass and patient-reported health status are positively associated and both significantly increase over the first 6 months of LVAD support. While muscle strength does not significantly change with time, it is significantly associated with patient-reported health status. Further research is necessary to fully evaluate the significance of restoring muscle mass and function to optimize patient-reported QoL.