PS-BPC09-1: SKELETAL MUSCLE MASS REDUCTION ASSOCIATED WITH INCREASED ARTERIAL VELOCITY PULSE INDEX AND TISSUE DAMAGE MARKER IN PATIENTS WITH CARDIOVASCULAR DISEASE

Abstract

Objectives: Reduction of skeletal muscle mass is the most important component of sarcopenia. Aging and chronic diseases, including chronic heart failure, are the causes of reduced skeletal muscle mass. However, little is known about the mechanism of skeletal muscle mass reduction in patients with cardiovascular disease (CVD). The purpose of this study was to assess the association between skeletal muscle mass reduction and the indicators of early and advanced arterial damages in CVD patients. Design and Methods: This was a single-center, retrospective cross-sectional analysis including 310 inpatients with CVD. Bioelectrical impedance assay was used to measure skeletal muscle index (SMI) as well as bioelectrical phase angle (PA), a marker of tissue damage. Arterial velocity pulse index (AVI) was assessed for advanced vascular damages, such as arterial stiffening and increased peripheral resistance, using a commercially available instrument. Flow-mediated vasodilation (FMD) was performed to assess early vascular damages, i.e. endothelial dysfunction, using a commercially available, high-resolution, ultrasound device. Results: The mean age was 72 years (male, 57.7%). Symptomatic heart failure (AHA/ACC stage C and D) was observed in 19.4%. Sarcopenia was diagnosed in 25.5% of the whole group, according to the Asian Working Group for Sarcopenia criteria. Sarcopenic patients showed higher AVI and narrower PA than non-sarcopenic patients, suggesting as having severer arterial stiffness and tissue damage. Single regression analysis showed that SMI associated with AVI, FMD, PA, age, male sex, hypertension, diabetes mellitus, and dyslipidemia, but not with CKD and heart failure. Stepwise multivariate regression analysis revealed that age, male sex, AVI, PA, and hypertension were independent factors for SMI in CVD patients, whereas FMD, diabetes mellitus, and dyslipidemia were not. Conclusion: AVI was a significant marker for detecting sarcopenia in CVD patients independently of age and male sex. In addition, skeletal muscle mass reduction was correlated with a tissue damage marker, PA. Therefore, it is suggested that advanced vascular damages resulting arterio-/arteriolo-sclerosis, rather than early endothelial dysfunction, might be attributed to the reduction of skeletal muscle mass, possibly through damages of skeletal muscle tissue in CVD patients.