Sarcopaenia complicating heart failure

Author:

Fonseca Guilherme Wesley Peixoto da12,von Haehling Stephan23

Affiliation:

1. Cardiovascular Rehabilitation and Exercise Physiology Unit, Heart Institute (InCor), University of São Paulo Medical School, Av. Dr. Enéas de Carvalho Aguiar, 44 - Cerqueira Cesar, 05403-900 São Paulo, Brazil

2. Department of Cardiology and Pneumology, University Medicine Göttingen (UMG), Robert-Koch-Straße 40, 37075 Göttingen, Germany

3. German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, Robert-Koch-Straße 40, 37075 Göttingen, Germany

Abstract

Abstract Sarcopaenia is defined as reduced skeletal muscle mass associated with either a decline in muscle strength or low physical performance. It has been shown to affect 17.5% of people worldwide, with a prevalence of 20% or higher in patients with heart failure (HF). Sarcopaenia has severe impact on mortality, physical capacity, and quality of life. Even though several mechanisms, such as autonomic imbalance, reduced muscle blood flow, increased inflammation, hormonal alterations, increased apoptosis, and autophagy have been proposed to fuel the pathogenesis of sarcopaenia, additional studies assessing the interaction of these conditions need to be conducted to elucidate how the presence of sarcopaenia can exacerbate the progression of HF and vice-versa. Resistance training combined with nutritional protein intake seems to be effective in the treatment of sarcopaenia, although current pharmacotherapies have not been extensively studied with this endpoint in mind. In conclusion, sarcopaenia is interwoven with HF and leads to worse exercise capacity in these patients. The mechanisms associated with this bilateral relationship between sarcopaenia and HF are still to be elucidated, leading to effective treatment, not only for the heart, but also for the skeletal muscle.

Funder

Heart Failure Association of the European Society of Cardiology

Publisher

Oxford University Press (OUP)

Subject

Cardiology and Cardiovascular Medicine

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