目的:心脏舒张功能障碍(左心室舒张功能障碍[LVDD])是众所周知的心力衰竭预测因子。我们假设肌少症与舒张功能障碍独立相关。我们旨在研究肌肉减少症与LVDD的最新共识定义之间的关联。
方法:我们纳入了心脏病门诊就诊的121名老年患者。我们遵循欧洲老年人肌肉减少症工作组2确认的肌肉减少症(存在低肌肉质量和低肌肉力量)的定义。我们通过Jamar液压手测力计通过生物阻抗分析和手握力来估计骨骼肌质量。通过体重指数调整骨骼肌质量。根据美国超声心动图协会的建议,通过测量的超声心动图参数确定LVDD。我们对舒张功能障碍的已知危险因素进行了多变量逻辑回归分析(即,年龄,性别,肥胖,吸烟,糖尿病,高血压,和缺血性心脏病)以检测肌肉减少症是否与舒张功能障碍独立相关。我们以比值比(OR)和95%置信区间(CI)给出结果。
结果:平均年龄为69.9±5.8岁,38.8%的参与者是男性。确诊的肌少症检出率为34.7%,舒张功能障碍占19.8%。在单变量分析中,肌肉减少症与舒张功能障碍相关(OR,6.7,95%CI,2.4-18.9)。回归分析表明,两个参数,肌肉减少症(或,7.4,95%CI,2.1-26.6,P=0.002)和肥胖(OR,5.0,95%CI,1.03-24.6,P=0.046),与舒张功能障碍有关。
结论:这项研究表明,少肌症是舒张功能不全的新危险因素,增加了其已知的风险因素。未来的纵向研究需要澄清其共同存在的因素。
OBJECTIVE: Cardiac diastolic dysfunction (left ventricular diastolic dysfunction [LVDD]) is a well-known predictor of heart failure. We hypothesized that sarcopenia is independently associated with diastolic dysfunction. We aimed to investigate the association of the most recent consensus definition of sarcopenia with LVDD.
METHODS: We included 121 older participants admitted to a cardiology outpatient clinic. We followed the European Working Group on Sarcopenia in Older People 2 definition of confirmed sarcopenia (presence of low muscle mass and low muscle strength). We estimated skeletal muscle mass with bioimpedance analysis and muscle strength by hand grip strength via a Jamar hydraulic hand dynamometer. Skeletal muscle mass was adjusted by body mass index. LVDD was determined by echocardiographic parameters measured per American Society of Echocardiography recommendations. We ran multivariate logistic regression analyses adjusted for well-known risk factors for diastolic dysfunction (i.e., age, sex, obesity, smoking, diabetes mellitus, hypertension, and ischemic heart disease) to detect whether sarcopenia was independently associated with diastolic dysfunction. We gave results in odds ratio (OR) and 95% confidence interval (CI).
RESULTS: Mean age was 69.9 ± 5.8 years, and 38.8% of participants were male. Confirmed sarcopenia was detected in 34.7%, and diastolic dysfunction was detected in 19.8%. In univariate analyses, sarcopenia was associated with diastolic dysfunction (OR, 6.7, 95% CI, 2.4-18.9). Regression analyses showed that two parameters, sarcopenia (OR, 7.4, 95% CI, 2.1-26.6, P = 0.002) and obesity (OR, 5.0, 95% CI, 1.03-24.6, P = 0.046), were associated with diastolic dysfunction.
CONCLUSIONS: This study revealed sarcopenia to be a new risk factor for diastolic dysfunction, adding to its known risk factors. Future longitudinal studies are needed to clarify the factors underlying their copresence.