Muscle status in patients with coronary artery disease and heart failure with preserved ejection fraction

Abstract

Aim. To evaluate the relationship between muscle status (MS) phenotypes (sarcopenia, dynapenia) and myocardial remodeling parameters and clinical characteristics in patients with stable coronary artery disease and heart failure with preserved ejection fraction (HFpEF). Material and methods . The study included patients with HFpEF of ischemic origin who underwent a clinical and paraclinical examination. Standard clinical and biochemical laboratory parameters, structural and functional cardiac parameters were assessed (echocardiography), and MS impairments were diagnosed (muscle strength, mass, and function determination). Sarcopenia and dynapenia were defined according to international criteria. Comparative, regression, and receiver operating characteristic analyses were conducted to identify independent predictors of impaired MS. Results. The proportion of women in the sarcopenia and dynapenia groups was higher than in the normal MS group (p=0,044). Sarcopenia was associated with lower values of left ventricular end-diastolic and systolic volumes, stroke volume, and left atrial volume (p<0,05). According to logistic regression, sarcopenia was independently associated with smaller values of left ventricular end-diastolic volume (odds ratio (OR) 0,98; 95% confidence interval (CI) 0,97-0,99) and smaller left atrial volume (OR 0,97; 95% CI 0,95-0,99); AUC=0,727. Dinapenia was characterized by a decrease in the strength and functionality of skeletal muscle tissue with preserved or increased muscle mass. Independent factors associated with dynapenia were female sex (OR 4,30; 95% CI 1,97-9,54), atrial fibrillation (OR 2,64; 95% CI 1,26-5,50), and a higher musculoskeletal index (OR 1,07; 95% CI 1,03-1,11); AUC=0,728. Conclusion. The phenotypes of aberrant MS in HFpEF are clinically and structurally heterogeneous. The obtained data emphasize the need for a comprehensive assessment of MS in this population.