Prognostic Impact of Upper and Lower Extremity Muscle Mass in Heart Failure

ESC Heart FailPublished 11 Oct 2022Prospective cohort study

Cite

Authors' conclusion

Both USM and LSM had a prognostic implication on mortality after discharge in HF, even though LSM may have been affected by leg oedema.

Study context

Population: Patients hospitalised with heart failure (HF) (71 ± 13 years; 59% men; LVEF 39 ± 16%), measured in stable state after decongestion92 (22.0%) died
Participants: 418 patients

Exposure: Upper vs lower extremity skeletal muscle mass (USM vs LSM) as predictors of all-cause mortality
Outcome: All-cause mortality after discharge
Follow-up: Median 37 months

Methodological detailssingle-centre, observational

As reported in the abstract

All-cause mortality

Per 1 kg; adjusted for age, sex, creatinine, haemoglobin, NYHA class, height2

Hazard ratio (95% CI)P value

USM

0.557(0.393–0.783)

P < 0.001

LSM

0.783(0.689–0.891)

P < 0.001

Per 1 kg, as printed

Sex-specific quartiles of USM/height2 and LSM/height2 associated with all-cause mortality (log-rank): P < 0.001

Observational data: associations, not effects.

Outcome	USM	LSM	P value
AUC for predicting all-cause mortalityComparable			P = 0.562
AUC (USM/height2)	0.557	Not reported in the abstract		LSM: not reported in the abstract
AUC (LSM/height2)	Not reported in the abstract	0.568		USM: not reported in the abstract
Muscle mass by sex
Men	5.29 ± 1.18	13.78 ± 3.20
Women	3.37 ± 0.68	9.19 ± 1.80
USM/LSM ratio by residual leg oedemaLeg oedema vs No oedema · suggests oedema influences measured LSM			P = 0.004

Muscle mass by sex — Correlation of USM with mid-upper arm circumference: r = 0.684, P < 0.001
Muscle mass by sex — Correlation of LSM with calf circumference: r = 0.822, P < 0.001

Prognostic Impact of Upper and Lower Extremity Muscle Mass in Heart Failure. ESC Heart Fail. Published 11 October 2022. doi:10.1002/ehf2.14195

Summarised from the published abstract; every number is checked against it