Mid‐arm muscle circumference as an indicator of exercise tolerance in chronic heart failure

Abstract

Skeletal muscle mass is associated with exercise tolerance in patients with chronic heart failure (CHF). Anthropometric indicators are used to evaluate skeletal muscle mass, as these can be easily assessed in clinical practice. However, the association between anthropometric indicators and exercise tolerance is unclear. This study aimed to investigate the association between anthropometric indicators and exercise tolerance in CHF patients. Methods:We evaluated 69 patients with CHF. Mid-arm circumference, mid-arm muscle circumference (MAMC), calf circumference and body mass index were measured as the anthropometric indicators. Exercise tolerance was evaluated according to the peak oxygen uptake (VO 2 ). Correlation analyses were carried out to determine the association between peak VO 2 and anthropometric indicators. Furthermore, univariate and multiple regression analyses were carried out using peak VO 2 as the dependent variable, and age, male, left ventricular ejection fraction, angiotensin II receptor blocker or angiotensin converting enzyme inhibitor, diuretics, B-type natriuretic peptide, estimated glomerular filtration rate, hemoglobin and anthropometric indicators as the independent variables.Results: There were significant positive correlations between the peak VO 2 and mid-arm circumference (r s = 0.378, P = 0.001), MAMC (r = 0.634, P < 0.001) and calf circumference (r = 0.292, P = 0.015). In multiple regression analysis, MAMC (β = 0.721, P < 0.001) and estimated glomerular filtration rate (β = 0.279, P = 0.007) were independent factors associated with peak VO 2 .Conclusions: MAMC is independently associated with peak VO 2 in CHF patients. Thus, MAMC could be an indicator of exercise tolerance, which is closely related to the severity and prognosis of CHF.

A prospective cohort study on the association of lean body mass estimated by mid‐upper arm muscle circumference with hypertension risk in Chinese residents

“… 15 , 16 , 17 However, studies about the relationship between MAMC and cardiovascular abnormalities are limited. 18 , 19…”

“…[15][16][17] However, studies about the relationship between MAMC and cardiovascular abnormalities are limited. 18,19 In addition, despite that positive associations of both MUAC and TST with hypertension have been reported, no study has disclosed which one was stronger associated with hypertension. 20,21 If the positive relationship between LBM and hypertension existed, MUAC, as a measurement of both fat and lean mass perhaps should be stronger associated with hypertension than TST.…”

“…As an easier obtained measurement, MAMC has been proven to be closely correlated to some other more accurate measurements based on DXA and CT in various populations 15–17 . However, studies about the relationship between MAMC and cardiovascular abnormalities are limited 18,19 …”

Assessing nutritional status in older adults requiring long‐term care: Interchangeability of bioelectrical impedance analysis and manual methods for upper arm anthropometric measurements

“…6,9 In particular, arm circumference (AC) and arm muscle circumference (AMC), which are measurements of the upper arm, are less affected by leg edema, which is more common in older adults than calf circumference and are considered nutritional indicators for older adults presenting various diseases. 10,11 However, the greater the number of examiners carrying out anthropometric measurements, the more inter-rater error occurs. Therefore, there is a need for a simple and reasonable evaluation method to determine the nutritional status of older adults requiring long-term care.…”

“…For these reasons, physical measurements are considered useful indicators of nutritional status and muscle mass, and are often used in the nutritional assessment of older adults 6,9 . In particular, arm circumference (AC) and arm muscle circumference (AMC), which are measurements of the upper arm, are less affected by leg edema, which is more common in older adults than calf circumference and are considered nutritional indicators for older adults presenting various diseases 10,11 . However, the greater the number of examiners carrying out anthropometric measurements, the more inter‐rater error occurs.…”