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Clinical Trial
. 2022 Oct;34(10):2493-2504.
doi: 10.1007/s40520-022-02189-7. Epub 2022 Aug 8.

Biomarkers and the quadriceps femoris muscle architecture assessed by ultrasound in older adults with heart failure with preserved ejection fraction: a cross-sectional study

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Clinical Trial

Biomarkers and the quadriceps femoris muscle architecture assessed by ultrasound in older adults with heart failure with preserved ejection fraction: a cross-sectional study

Iván José Fuentes-Abolafio et al. Aging Clin Exp Res. 2022 Oct.

Abstract

Background: Sarcopenia is an important comorbidity in patients with heart failure with preserved ejection fraction (HFpEF). The ultrasound (US) assessment has all the advantages of being used in primary care to assess muscle quantity and quality. Some biomarkers could be indicative of muscle mass loss.

Aims: To describe the quantitative and qualitative characteristics of the quadriceps femoris assessed by US in older adults with HFpEF and to assess the relationship of the blood and urinary biomarkers, the polypharmacy and comorbidities with US outcomes in older adults with HFpEF.

Methods: A cross-sectional study was conducted. 76 older adults with HFpEF were included. The quadriceps femoris muscle thickness (MT, cm), the subcutaneous fat tissue thickness (FT, cm), the muscle echo intensity (MEI) and the subcutaneous fat tissue echo intensity (FEI) were assessed by US in a non-contraction (non-con) and contraction (con) situations. Polypharmacy, comorbidities, blood and urine biomarkers were also collected.

Results: The carbohydrate antigen 125 (CA-125), the folic acid and the urine creatinine shared the 86.6% variance in the non-con MT, adjusted by age, sex and body mass index (BMI). The folic acid shared the 38.5% of the variance in the con MT, adjusted by age, sex and BMI. The glycosylated haemoglobin explained the 39.6% variance in the non-con MEI, adjusted by age, sex and BMI. The chlorine (Cl-) explained the 40.2% of the variance in the non-con FT, adjusted by age, sex and BMI. The polypharmacy and the folic acid explained the 37.9% of variance in the non-con FEI, while the polypharmacy and the thyrotropin (TSH) shared the 44.4% of variance in the con FEI, both adjusted by age, sex and BMI. No comorbidities, polypharmacy, or blood and urinary biomarkers could explain the con MEI and the con FT variance.

Conclusions: Blood and urinary biomarkers obtained in routine analyses could help clinicians detect US outcome changes in older adults with HFpEF and identify a worsening of sarcopenia.

Trial registration: NCT03909919. April 10, 2019. Retrospectively registered.

Keywords: Blood biomarkers; Heart failure; Muscle thickness; Older adults; Ultrasound; Urinary biomarkers.

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Conflict of interest statement

The authors certify that they have no affiliations with or financial involvement in any organisation or entity with a direct financial interest in the subject matter or materials discussed in the article. Authors, their immediate family, and any research foundation with which they are affiliated have not received any financial payments or other benefits from any commercial entity related to the subject of this article.

Figures

Fig. 1
Fig. 1
The landmark and the patients´ position for the ultrasound assessment
Fig. 2
Fig. 2
Range of interest and selected areas

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