目的：分析上海部分地区老年射血分数保留型心力衰竭（心衰）（heart failure with preserved ejection fraction，HFpEF）患者合并肌少症的预后情况及相关危险因素。 方法：方法：连续选取2018年1月至2020年6月上海交通大学医学院附属瑞金医院及协作社区卫生服务中心、护理院住院收治的261例年龄≥60岁老年HFpEF患者，将受试者根据是否合并肌少症进行分组，收集受试者的相关临床资料。随访终点为受试者因心衰再入院和（或）全因死亡，随访截止时间为2022年12月。根据结果绘制Kaplan-Meier生存分析曲线并进行Log-Rank检验比较组间预后情况，应用单因素和多因素Cox比例风险回归模型分析不良预后的相关危险因素。 结果：2组平均随访（38.6±11.5）个月，肌少症组平均（37.4±13.0）个月，对照组平均（39.1±9.3）个月。Kaplan-Meier生存分析曲线结果显示肌少症组预后较无肌少症组明显更差（P<0.05），多因素Cox回归分析显示肌少症是老年HFpEF患者不良预后的独立危险因素（P<0.05）。 结论：肌少症是老年HFpEF患者不良预后的独立预测因子。在临床实践中应重视对老年HFpEF患者肌少症的早期识别与管理，可能有助于改善患者预后。

Objective To explore the prognosis and related risk factors of sarcopenia in elderly patients with heart failure and preserved ejection fraction (HFpEF) in some areas of Shanghai. Methods A total of 261 elderly patients (age ≥60 years) with HFpEF were consecutively enrolled from January 2018 to June 2020 at Ruijin Hospital，Shanghai Jiao Tong University School of Medicine and collaborating community health service centers/nursing homes. The subjects were grouped according to the presence of sarcopenia, and the relevant clinical data were collected. The follow-up endpoint was subject’s readmission for heart failure and (or) all-cause death, and the deadline of follow-up was December 2022. The Kaplan-Meier survival analysis curve and Log-Rank test were performed to compare the outcome between the two groups, and univariate and multivariate Cox proportional hazards regression models were applied to analyze the relevant risk factors of adverse outcome. Results The average time of follow-up was (38.6±11.5) months in the two groups, was (37.4±13.0) months in the sarcopenia group and (39.1±9.3) months in the control group, respectively. The results of Kaplan-Meier survival analysis curve showed that the sarcopenia group had significantly worse prognosis than that in the control group (P<0.05), and multivariate Cox regression analysis showed that sarcopenia was an independent risk factor for poor prognosis in elderly patients with HFpEF (P<0.05). Conclusions This study indicates that sarcopenia was an independent predictor of adverse prognosis in elderly patients with HFpEF. These findings highlight the clinical importance of early identification and management of sarcopenia in these patients, which may help improve clinical outcomes.