Abstract：
OBJECTIVE: A high extracellular water (ECW) to intracellular water (ICW) ratio of skeletal muscle as assessed by bioelectrical impedance analysis is reportedly associated with loss of muscle strength. However, the validity of this index for heart failure (HF), which is likely associated with changes in the water distribution, is unclear.
RESULTS: This study involved 190 patients with HF. The total ECW and ICW of both upper and lower extremities were measured, and a high ECW/ICW ratio was defined as an ECW/ICW ratio higher than the median (≥0.636 for men, ≥0.652 for women). Low muscle strength was defined as reduced handgrip strength according to the criteria established by the Asian Working Group for Sarcopenia. Patients with a high ECW/ICW ratio had a lower handgrip strength (21.1 ± 8.1 kg vs. 27.6 ± 9.3 kg, P ≤ 0.05) and 6 min walk distance (329 ± 116 m vs. 440 ± 114 m) than those with a low ECW/ICW ratio. An increasing ECW and/or decreasing ICW was associated with a higher ECW/ICW ratio and a lower handgrip strength (P < 0.05). In the multivariate logistic regression analysis, a high ECW/ICW ratio and low skeletal muscle mass were independently associated with low muscle strength (P < 0.05).
CONCLUSIONS: A high ECW/ICW ratio in limb muscles, that is, the water imbalance of increasing ECW and/or decreasing ICW, is useful in assessing muscle quality in patients with HF.
RESULTS: This study involved 190 patients with HF. The total ECW and ICW of both upper and lower extremities were measured, and a high ECW/ICW ratio was defined as an ECW/ICW ratio higher than the median (≥0.636 for men, ≥0.652 for women). Low muscle strength was defined as reduced handgrip strength according to the criteria established by the Asian Working Group for Sarcopenia. Patients with a high ECW/ICW ratio had a lower handgrip strength (21.1 ± 8.1 kg vs. 27.6 ± 9.3 kg, P ≤ 0.05) and 6 min walk distance (329 ± 116 m vs. 440 ± 114 m) than those with a low ECW/ICW ratio. An increasing ECW and/or decreasing ICW was associated with a higher ECW/ICW ratio and a lower handgrip strength (P < 0.05). In the multivariate logistic regression analysis, a high ECW/ICW ratio and low skeletal muscle mass were independently associated with low muscle strength (P < 0.05).
CONCLUSIONS: A high ECW/ICW ratio in limb muscles, that is, the water imbalance of increasing ECW and/or decreasing ICW, is useful in assessing muscle quality in patients with HF.
摘要：
目的：据报道，通过生物电阻抗分析评估的骨骼肌的高细胞外水（ECW）与细胞内水（ICW）比率与肌肉力量的损失有关。然而,该指数对心力衰竭（HF）的有效性，这可能与水分布的变化有关，不清楚。
结果：本研究涉及190例HF患者。测量上肢和下肢的总ECW和ICW，高ECW/ICW比率被定义为ECW/ICW比率高于中位数（男性≥0.636，女性≥0.652)。根据亚洲肌肉减少症工作组制定的标准，将低肌肉力量定义为握力降低。ECW/ICW比率高的患者的握力较低（21.1±8.1kg与27.6±9.3kg,P≤0.05)和6分钟步行距离(329±116mvs.440±114m）比ECW/ICW比值低的那些。ECW增加和/或ICW减少与更高的ECW/ICW比率和更低的握力相关(P<0.05)。在多变量逻辑回归分析中，高ECW/ICW比值和低骨骼肌质量与低肌力独立相关(P<0.05)。
结论：肢体肌肉的ECW/ICW比率很高，也就是说,增加ECW和/或减少ICW的水不平衡，可用于评估HF患者的肌肉质量。
结果：本研究涉及190例HF患者。测量上肢和下肢的总ECW和ICW，高ECW/ICW比率被定义为ECW/ICW比率高于中位数（男性≥0.636，女性≥0.652)。根据亚洲肌肉减少症工作组制定的标准，将低肌肉力量定义为握力降低。ECW/ICW比率高的患者的握力较低（21.1±8.1kg与27.6±9.3kg,P≤0.05)和6分钟步行距离(329±116mvs.440±114m）比ECW/ICW比值低的那些。ECW增加和/或ICW减少与更高的ECW/ICW比率和更低的握力相关(P<0.05)。在多变量逻辑回归分析中，高ECW/ICW比值和低骨骼肌质量与低肌力独立相关(P<0.05)。
结论：肢体肌肉的ECW/ICW比率很高，也就是说,增加ECW和/或减少ICW的水不平衡，可用于评估HF患者的肌肉质量。
