Muscle wasting in young patients with dilated cardiomyopathy

Abstract

BackgroundMuscle wasting can be accelerated by chronic diseases such as heart failure and is one of the major causes of disability, morbidity, and mortality in this population. We aimed to investigate the incidence of muscle wasting and its associated factors in dilated cardiomyopathy patients younger than 55 years of age.MethodsBetween April 2014 and December 2015, all symptomatic patients with a diagnosis of non‐ischaemic dilated cardiomyopathy who were referred to heart failure clinic were included in our study.Dual energy X‐ray absorptiometry was used to evaluate body composition and identify muscle wasting. Muscle mass was calculated as the ratio of an individual's total lean mass of legs and arms (also called appendicular skeletal muscle) to their squared height (kg/m2). The muscle mass values of less than 5.45 kg/m2 for women and 7.26 kg/m2 for men were considered low.ResultsA total of 55 patients (32 male) were included. The mean (standard deviation) of age was 37.3 (10.1) years, and the mean of left ventricular ejection fraction was 21.4%. Most of the patients were in the New York Heart Association classes of II and II–III. Twenty‐six patients (47.3%) met criteria for muscle wasting. Patients with muscle wasting had lower left ventricular ejection fraction, lower 6‐min walk distance, and higher New York Heart Association function class and hospitalization rate.ConclusionsWe concluded that muscle wasting might be present in younger patients with heart failure, particularly in those who are in worse clinical condition.

Abdominal skeletal muscle mass as a predictor of mortality in Japanese patients undergoing left ventricular assist device implantation

“…Therefore, there might be more accurate and appropriate threshold for muscle wasting. 17,18,28,29 By contrast, the abdominal muscle mass may have some different implications independent of the inactivity level; indeed, the parameters of heart failure status did not correlate with abdominal muscle mass in our study. 25 The information on abdominal muscle mass calculated by CT has been reported to have less utility than the information on muscle function (such as the grip strength).…”

“…[14][15][16] The prevalence of sarcopenia in patients with heart failure is higher at 19.5% than that in healthy subjects of the same age. 18 Evidence has been mounting on sarcopenia or other skeletal muscle parameters being a risk marker for adverse outcomes in heart failure. For example, a report indicated sarcopenia in as much as 47% of young patients (<55 years of age) suffering from dilated cardiomyopathy.…”

Muscle wasting and sarcopenia in heart failure and beyond: update 2017

“…In CHF, the prevalence of patients with sarcopenia is higher at 20% compared to healthy subjects of the same age . A recent study suggests an even higher prevalence of 47% in young patients (<55 years of age) suffering from dilated cardiomyopathy . This may be caused by an abnormal energy metabolism coupled with mitochondrial dysfunction, as well as a transition of myofibers from type I to type II .…”

Skeletal muscle wasting in chronic heart failure

“…44 Despite this, there are still several definitions of sarcopenia with diverse cut-off values 45,46 that were all confirmed to be independent predictors of adverse outcomes. 49 This particularly high incidence may be due to mitochondrial dysfunction combined with an abnormal energy metabolism and a transition of type I to type II myofibres. 48 An even higher prevalence of sarcopenia (47%) has recently been suggested in patients below the age of 55 years suffering from dilated cardiomyopathy.…”