Cardiac Manifestations of Sarcopenia

• Published in: The Journal of nutrition, health & aging health & aging, 2020-05, Vol.24 (5), p.478-484
• Main Authors: Yang, X., Woo, Jean, Ting Lui, L., Li, Q., Fai Cheng, K., Fan, Y., Yau, F., Lee, A. P. W., Lee, J. S. W., Fung, E.
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Aging; Cardiac stress tests; Cardiovascular Diseases - etiology; Cardiovascular Diseases - pathology; Echocardiography - methods; Ejection fraction; Female; Geriatric Assessment; Geriatrics/Gerontology; Hand Strength - physiology; Heart failure; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Natriuretic Peptide, Brain - metabolism; Neurosciences; Nutrition; Older people; Primary Care Medicine; Quality of Life Research; Sarcopenia; Sarcopenia - complications; Surveys and Questionnaires
• ISSN: 1279-7707; 1760-4788
• DOI: 10.1007/s12603-020-1358-8

Objectives Screening questions for sarcopenia used in the community (SARC-F) may be regarded as indicators of exercise tolerance. Design Observational study. Setting We tested the hypothesis that community-living older people who are screened positive for sarcopenia using the SARC-F tool but without a history of heart failure (HF) have a higher prevalence of cardiac abnormalities compared with those who are SARC-F negative. Participants Participants were recruited from a territory-wide primary care needs assessment for older people based in community centres, and from non-acute hospitals in the same region as the study centre. Measurements Participants with a total score of >=4 and who did not have any history of HF were invited to attend for further cardiac assessment. Grip strength, walking speed, and the 6-minute walk test and echocardiography were carried out. Patients with frailty and at least Grade II diastolic dysfunction were considered to have heart failure with preserved ejection fraction (HFpEF) if they also had concomitant elevated N-terminal prohormone of B-type natriuretic peptide (NT-proBNP) of at least 300 pg/ml. Results Diastolic dysfunction (DD) was significantly associated with SARC-F score >=4 and higher circulating NT-proBNP levels. ROC curves evaluating the predictive values of SARC-F, HGS and gait speed for DD showed that a combination of SARC-F and HGS or gait speed provided significant incremental value in predicting DD. Conclusions Community living older people with sarcopenia detected using a simple questionnaire have a higher prevalence of DD accompanied by elevated NT proBNP. Addition of hand grip strength or walking speed improve the magnitude of the association. SARC-F may be used as a tool to detect early cardiac dysfunction in the community.