Enhanced Echo Intensity of Skeletal Muscle Is Associated With Exercise Intolerance in Patients With Heart Failure

Nakano, Ikuo; Hori, Hiroaki; Fukushima, Arata; Yokota, Takashi; Kinugawa, Shintaro; Takada, Shingo; Yamanashi, Katsuma; Obata, Yuki; Kitaura, Yasuyuki; Kakutani, Naoya; Abe, Takahiro; Anzai, Toshihisa

doi:10.1016/j.cardfail.2019.09.001

Cited by 21 publications

(19 citation statements)

References 46 publications

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“…More recently, the International Society of Physical and Rehabilitation Medicine special interest group on sarcopenia included the quadriceps thickness as an indicator of muscle mass in the diagnosis criteria of sarcopenia. 32 Furthermore, intramuscular adipose tissue of the quadriceps is related to swallowing ability, 33 , 34 nutritional status, 35 aerobic capacity, 36 and occurrence of hospital‐associated complications (i.e. delirium, functional decline, incontinence, falls, pressure injuries, and nosocomial infections).…”

Section: Discussionmentioning

confidence: 99%

Longitudinal relationship between intramuscular adipose tissue of the quadriceps and activities of daily living in older inpatients

Akazawa

Kishi²,

Hino³

et al. 2021

J cachexia sarcopenia muscle

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Background The longitudinal relationship between intramuscular adipose tissue of the quadriceps and activities of daily living (ADL) in older inpatients remains unclear. This study aimed to examine whether decrease of intramuscular adipose tissue of the quadriceps in older inpatients is related to the recovery of ADL than increase of muscle mass. Methods This longitudinal study included 202 inpatients aged ≥65 years [median age: 83.0 (77.0–88.0), 56.4% female]. Recovery of ADL during hospital stay was assessed using the change in Barthel index (BI) score (i.e. BI score at discharge minus BI score at admission) and BI score at discharge. Intramuscular adipose tissue and muscle mass of the quadriceps were assessed using echo intensity and muscle thickness on ultrasound images, respectively. Higher echo intensity indicates greater intramuscular adipose tissue. Multiple regression analysis was performed to identify the factors independently associated with the change in BI score and BI score at discharge. Changes in quadriceps echo intensity and thickness and subcutaneous fat thickness of the thigh, quadriceps echo intensity and thickness, and subcutaneous fat thickness of the thigh at admission, age, sex, days from onset disease, BI score at admission, and disease were set as independent variables. Results The means of the change in quadriceps echo intensity and thickness were −2.3 ± 15.7 and 0.1 ± 0.4 cm, respectively. The median of the change in BI score was 15.0 (0.0–30.0). The quadriceps echo intensity at discharge was significantly lower than at admission (P = 0.043). The quadriceps thickness (P = 0.004) and BI score at discharge (P < 0.001) were significantly higher than those at admission. Change in quadriceps echo intensity was independently and significantly associated with the change in BI score (β = −0.25, P = 0.006) and BI score at discharge (β = −0.18, P = 0.006). In contrast, change in quadriceps thickness was not independently and significantly associated with the change in BI score (β = 0.09, P = 0.244) and BI score at discharge (β = 0.06, P = 0.244). Conclusions Our study indicates that a decrease of intramuscular adipose tissue of the quadriceps is related to the recovery of ADL than an increase of muscle mass in older inpatients. Intramuscular adipose tissue of the quadriceps in older inpatients is considered to be a predictor for the recovery of ADL, and intervening for intramuscular adipose tissue may be important for improving ADL in older inpatients.

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Section: Discussionmentioning

confidence: 99%

Longitudinal relationship between intramuscular adipose tissue of the quadriceps and activities of daily living in older inpatients

Akazawa

Kishi²,

Hino³

et al. 2021

J cachexia sarcopenia muscle

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“…In this sense, assessing the muscle quality [ 32 ] and local microcirculatory response differences among HFpEF and HFrEF patients and the association with muscle strength and cardiorespiratory fitness is clinically relevant [ 33 ], paving new secondary prevention and rehabilitation treatment alternatives [ 34 ]. A recent study described higher quadriceps echo intensity, muscle thickness (cm), and muscle mass (Kg) values in HF patients compared to a control group and its association with poor exercise capacity in HF [ 35 ]. The EI of the quadriceps femoris correlated physical performance in sedentary older adults and was the strongest predictor of this functional test, with 30% of the variance explained by the EI [ 36 , 37 , 38 ].…”

Section: Introductionmentioning

confidence: 99%

Muscle-Skeletal Abnormalities and Muscle Oxygenation during Isokinetic Strength Exercise in Heart Failure with Preserved Ejection Fraction Phenotype: A Cross-Sectional Study

Vale-Lira

Turri-Silva

Verboven

et al. 2022

IJERPH

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Exercise intolerance, a hallmark of patients with heart failure (HF), is associated with muscle weakness. However, its causative microcirculatory and muscle characteristics among those with preserved or reduced ejection fraction (HFpEF or HFrEF) phenotype is unclear. The musculoskeletal abnormalities that could result in impaired peripheral microcirculation are sarcopenia and muscle strength reduction in HF, implying lowered oxidative capacity and perfusion affect transport and oxygen utilization during exercise, an essential task from the microvascular muscle function. Besides that, skeletal muscle microcirculatory abnormalities have also been associated with exercise intolerance in HF patients who also present skeletal muscle myopathy. This cross-sectional study aimed to compare the muscle microcirculation dynamics via near-infrared spectroscopy (NIRS) response during an isokinetic muscle strength test and ultrasound-derived parameters (echo intensity was rectus femoris muscle, while the muscle thickness parameter was measured on rectus femoris and quadriceps femoris) in heart failure patients with HFpEF and HFrEF phenotypes and different functional severities (Weber Class A, B, and C). Twenty-eight aged-matched patients with HFpEF (n = 16) and HFrEF (n = 12) were assessed. We found phenotype differences among those with Weber C severity, with HFrEF patients reaching lower oxyhemoglobin (O2Hb, μM) (−10.9 ± 3.8 vs. −23.7 ± 5.7, p = 0.029) during exercise, while HFpEF reached lower O2Hb during the recovery period (−3.0 ± 3.4 vs. 5.9 ± 2.8, p = 0.007). HFpEF with Weber Class C also presented a higher echo intensity than HFrEF patients (29.7 ± 8.4 vs. 15.1 ± 6.8, p = 0.017) among the ultrasound-derived variables. Our preliminary study revealed more pronounced impairments in local microcirculatory dynamics in HFpEF vs. HFrEF patients during a muscle strength exercise, combined with muscle-skeletal abnormalities detected via ultrasound imaging, which may help explain the commonly observed exercise intolerance in HFpEF patients.

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“…Respiratory exchange ratio (RER) can be used to indicate the body's substrate utilization of energy and the presence of lactic acid (Nakano et al, 2019). During regular activity, a mixture of the nutrient is usually used.…”

Section: Introductionmentioning

confidence: 99%

Effect of Exercise and Weight Loss in Polycystic Ovarian Syndrome among Obese Women

Cochrane¹,

Kamalden²,

Davey³

et al. 2021

JST

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Ovulation and fertility can be improved by weight loss in obese women with Polycystic Ovarian Syndrome (PCOS). The aim of this study was to investigate the effectiveness of a twelve-week supervised exercise program in combination with dietary restrictions for obese women with PCOS. The study is a quasi-experimental research and used an experimental pre- and post-test design. Fifteen women recruited from Fertility Clinic, Jessops Hospital for Women, Sheffield took part in this study. Respiratory exchange ratio (RER), heart rate, perceived exertion (RPE), and Houston non-exercise activity code were recorded. Height, weight, and body girth measurements were taken to calculate body mass index, fat percentage, and lean body weight. The intervention group lost an average of 3.1 kg and gained 3.45 kg of lean body weight. Loss of fat percentage was 12.1%. No significant difference was found in the control group. The RER and heart rate value decreased for the same workload in the intervention group, indicating higher tolerance towards exercise intensity. However, the changes for both groups were not significant. The average group compliance rate was 53% (at least two sessions per week). Bearing in mind the small sample size (n=4) for control, the improvement in fitness, significant weight loss, and body composition change (increase in fat-free mass) was achieved in this study. Twelve weeks of exercise, combined with dietary advice, were sufficient to benefit PCOS obese women. The research has achieved a commendable weight-loss objective and has demonstrated increases in standards of fitness among obese women.

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Enhanced Echo Intensity of Skeletal Muscle Is Associated With Exercise Intolerance in Patients With Heart Failure

Cited by 21 publications

References 46 publications

Longitudinal relationship between intramuscular adipose tissue of the quadriceps and activities of daily living in older inpatients

Longitudinal relationship between intramuscular adipose tissue of the quadriceps and activities of daily living in older inpatients

Muscle-Skeletal Abnormalities and Muscle Oxygenation during Isokinetic Strength Exercise in Heart Failure with Preserved Ejection Fraction Phenotype: A Cross-Sectional Study

Effect of Exercise and Weight Loss in Polycystic Ovarian Syndrome among Obese Women

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