Study Of Factors Associated With Chronic Heart Failure Combined With Sarcopenia In Elderly Patients

Research Background and Objectives:Chronic heart failure(CHF)is the end stage of cardiovascular disease,and it is a common clinical syndrome with difficulty in treatment.Sarcopenia is an age-related disease,and when elderly patients with CHF are combined with sarcopenia,it further decreases their activity tolerance and increases their risk of adverse effects such as falls and disability.The pathogenesis,mechanisms and factors affecting sarcopenia in elderly patients with CHF are not yet fully understood,which makes it easy for medical professionals to neglect the prevention and treatment of sarcopenia in their daily clinical work,so there is an increasing need for related research.The objective of this study was to compare the differences in general clinical data,serum laboratory markers,cardiac assessment markers,and skeletal muscle parameters between the sarcopenia and non-sarcopenia groups of patients with CHF.and analyzed the incidence of combined sarcopenia in elderly patients with CHF and its possible influencing factors to provide reference for the screening,prevention and treatment of combined sarcopenia in elderly patients with CHF.Methods:A total of 130 patients who were clearly diagnosed with CHF in our cardiovascular medicine department and geriatric center were selected.The Bioelectrical impedance analysis(BIA)method was used to calculate the Appendicular Skeletal Muscle Mass Index(ASMI)and to assess the dominant hand muscle strength and somatic functional status,and the elderly patients with CHF were divided into two groups The differences in general clinical data,serum laboratory indexes,cardiac parameters and correlation with sarcopenia were compared between the two groups to investigate the factors influencing the combination of sarcopenia in elderly patients with CHF.SPSS 26.0 statistical software was used for data analysis,and differences were considered statistically significant at P < 0.05.Results:1 A total of 130 elderly patients with CHF were enrolled,of which 65(50%)were in the sarcopenia group.Compared with the sarcopenia group,the non-sarcopenia group had a lower age level,a lower prevalence of arrhythmia,a higher body mass index(BMI),and a higher percentage of obesity and overweight.(2)When comparing the serological laboratory indicators between the two groups,the serum albumen(ALB)level was lower in the sarcopenia group.(3)Age,composition ratio of obesity or overweight,BMI,ALB,uric acid,creatinine,sarcopenia index,total cholesterol,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol,left ventricular ejection fraction,and left ventricular mass index were correlated with ASMI(P < 0.05).(4)Analysis of multifactorial logistic regression models showed that BMI(OR=0.78,95%CI:0.685～0.887,P<0.01),age(OR=1.063,95% CI:1.006～1.123,P=0.029),and ALB(OR=0.86,95%CI:0.760～0.974,P= 0.017)were independent influences on the occurrence of sarcopenia.(5)The area under the receiver operating characteristic(ROC)curve for BMI predicting sarcopenia in elderly CHF combined was 0.730,95% CI: 0.645～0.816,with a sensitivity of 60% and specificity of 78.5%;the area under the ROC curve for ALB predicting sarcopenia in elderly CHF combined was 0.661,95% CI: 0.568 ～0.755,with a sensitivity of 67.7% and the specificity was 64.6%.The area under the ROC curve for the combination of the two was 0.765,95% CI: 0.684～0.847,with a sensitivity of 64.6% and a specificity of 78.5%.Conclusion :1.The high prevalence of sarcopenia among elderly CHF inpatients suggests that physicians should pay more attention to the combination of sarcopenia in elderly CHF patients.2.The indicators for Age,ALB level and BMI are independent factors influencing the combination of sarcopenia in elderly CHF patients.3.BMI,ALB level and the combined index of both have good assessment value for the occurrence of sarcopenia.