Heart failure & cardiomyopathies
Diagnostic Value of Computed Tomography-Based Muscle Quality and Metabolic Signatures in Heart Failure with Sarcopenia
Authors' conclusion
Single-slice abdominal CT provides accurate sarcopenia diagnosis in HF patients with reduced muscle strength, with muscle quality rather than quantity determining physical performance. Specific amino acid profiles associated with muscle quality changes suggest potential therapeutic targets for preventing sarcopenia progression.
Study context
- Population
- Heart failure (HF) patients who underwent dual-energy X-ray absorptiometry (DXA), abdominal computed tomography (CT) imaging, and amino acid profilingof whom 186 had complete sarcopenia assessment, 73 ± 13 years old, 41% females
- Participants
- 212 patients
- Exposure
- CT-measured skeletal muscle area index (SMI) combined with grip strength against sarcopenia diagnosed by the Asian Working Group for Sarcopenia 2019 criteria using DXA-measured appendicular skeletal muscle mass index and grip strength
- Outcome
- Diagnostic accuracy of CT-measured SMI combined with grip strength for sarcopenia
Main finding
As reported in the abstract
| Group | AUC | Optimal cut-off |
|---|---|---|
| Males | 0.96 | 54 cm²/m² |
| Females | 0.88 | 40 cm²/m² |
AUC
Males0.96
Females0.88
Optimal cut-off
Males54 cm²/m²
Females40 cm²/m²
Observational data: associations, not effects.
Further findings
AUC
| Outcome | MMA | SMI | P value |
|---|---|---|---|
| Prediction of severe sarcopenia in malesHigher predictive value with MMA | 0.81 | 0.54 | P = 0.039 |
SMI and mean muscle attenuation (MMA) by sarcopenia severity
- SMI was similarly reduced in non-severe and severe sarcopenia patients
- Mean muscle attenuation (MMA) was decreased exclusively in patients with severe sarcopenia
CT-measured indices and low physical performance
- Decreased MMA remained the only CT-measured index significantly associated with low physical performance
- Multivariable analysis adjusted for age, sex, HF functional class and diabetes
Amino acids and MMA
- Leucine, β-alanine and 3-methylhistidine and the Fischer ratio were significantly associated with MMA, independent of SMI, sex, age, and body mass index
Original publication
Diagnostic Value of Computed Tomography-Based Muscle Quality and Metabolic Signatures in Heart Failure with Sarcopenia. ESC Heart Fail. Published 1 August 2025. doi:10.
Summarised from the published abstract; every number is checked against it