Prognostic factor analysis of sarcopenia in elderly patients with heart failure and preserved ejection fraction

doi:10.16138/j.1673-6087.2025.03.05

Abstract

Abstract:

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.

Key words: Heart failure with preserved ejection fraction, Sarcopenia, Prognosis, Risk factor

CLC Number:

R541.6

YANG Qirui, BAI Tingting, JIANG Qianwen, ZHANG Weiqi, LU Yiyin, ZHAO Wei, WU Fang, LI Feika. Prognostic factor analysis of sarcopenia in elderly patients with heart failure and preserved ejection fraction[J]. Journal of Internal Medicine Concepts & Practice, 2025, 20(03): 210-215.

Figures/Tables 4

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References 24

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项目	非肌少症组(n=174)	肌少症组(n=87)	合计(n=261)	χ²/Z/t	P
性别				0.21	0.774
男性	142	73	215
女性	32	14	46
年龄	86.5 (81~91)	90.0 (86~95)	88.0 (81~95)	-4.30	<0.001
原发性高血压[n(%)]	131 (75.29)	65 (74.71)	196 (75.10)	-0.25	0.858
糖尿病[n(%)]	74 (42.53)	39 (44.83)	113 (43.30)	-0.85	0.380
冠心病[n(%)]	88 (50.57)	45 (51.72)	133 (50.96)	-0.33	0.772
血红蛋白(g/L)	125.5 (109.0~140.0)	123.0 (110.5~136.0)	124.0(109.0~140.0)	-0.88	0.379
1,25-OH-VitD₃(nmol/L)	47.6(36.3~57.3)	36.1(26.0~48.1)	44.5(26.0~57.3)	-4.31	<0.001
Hcy(μmol/L)	11.4 (9.6~13.9)	18.3 (13.3~22.2)	12.8 (9.6~22.2)	-6.98	0.192
血清白蛋白(g/L)	38 (34~40)	37 (33~39)	37 (33~40)	-1.71	0.088
血肌酐(μmol/L)	91 (78~111)	84 (72~100)	87 (72~111)	-3.04	0.002
CRP(mg/L)	3 (1.0~11.8)	2 (0.7~7.5)	2.19 (0.7~11.6)	-1.58	0.114
pro-BNP(pg/mL)	404.2(187.6~1 009.5)	398.4(189.0~884.3)	402.0(187.6~1 009.5)	-0.10	0.921
BMI(kg/m²)	25.6±3.0	22.1±3.4	24.4±3.5	8.70	<0.001
SMI(kg/m²)	7.8 (7.4~8.7)	6.4 (5.9~6.7)	7.4 (5.9~8.7)	-11.53	<0.001
步速(m/s)	1 (0.7~1.2)	0.7 (0.5~0.9)	0.89(0.5~1.2)	-5.30	<0.001
手握力(kg)	28.6±8.7	21.7±5.5	26.3±8.4	7.91	<0.001
SPPB评分(分)	11 (8~12)	8 (5~10)	10 (5~12)	-4.81	<0.001

项目	HR	CI	P
性别	0.952	0.512~1.740	0.873
年龄	1.106	1.064~1.148	<0.001
血红蛋白	0.981	0.971~0.992	<0.001
1,25-OH-VitD₃	0.986	0.975~1.001	0.061
Hcy	1.013	0.982~1.046	0.415
血清白蛋白	0.903	0.857~0.951	<0.001
血肌酐	0.998	0.993~1.003	0.360
CRP	1.003	0.995~1.010	0.500
BNP	1.000	1.000~1.000	0.004
BMI	0.969	0.911~1.031	0.323
SMI	0.843	0.704~1.009	0.063
肌少症	1.843	1.158~2.933	0.010
步速	0.162	0.081~0.324	<0.001
手握力	0.971	0.946~0.997	0.029
SPPB评分	0.853	0.797~0.913	<0.001

项目	HR	CI	P
血红蛋白	0.996	0.982~1.010	0.547
血清白蛋白	0.944	0.885~1.006	0.077
BNP	1.000	1.000~1.000	0.226
肌少症	1.578	0.919~2.710	0.010
步速	0.229	0.078~0.670	0.007
手握力	1.029	0.992~1.067	0.126
SPPB评分	0.958	0.865~1.062	0.416