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. 2023 Mar 9:10:1132519.
doi: 10.3389/fcvm.2023.1132519. eCollection 2023.

Quantitative evaluation of gastrocnemius medialis mass in patients with chronic heart failure by gray-scale ultrasound and shear wave elastography

Qiyu Yao  1 , Yinglun Zhang  1 , Jun Wu  2 , Hua Shu  1 , Xinhua Ye  1 , Ao Li  1
Affiliations

Quantitative evaluation of gastrocnemius medialis mass in patients with chronic heart failure by gray-scale ultrasound and shear wave elastography

Qiyu Yao et al. Front Cardiovasc Med. .

Abstract

Objective: To assess the usefulness of gray-scale ultrasound (US) and shear wave elastography (SWE) in assessing the condition of the skeletal muscles in patients with chronic heart failure (CHF).

Methods: We prospectively compared 20 patients with clinically diagnosed CHF and a control population of 20 normal volunteers. The gastrocnemius medialis (GM) of each individual in the rest and the contraction position was assessed using gray-scale US and SWE. The quantitative US parameters including the fascicle length (FL), pinnation angle (PA), echo intensity (EI), and Young's modulus of the muscle were measured.

Results: In the CHF group compared with the control group, in the rest position, there was a significant difference in EI, PA, and FL of the GM (P < 0.001), but no statistically significant difference in Young's modulus values (P > 0.05); however, in the contraction position, all parameters were statistically different between the two groups (P < 0.001). In the different subgroups of the CHF group grouped according to New York Heart Association staging (NYHA) or left ventricular ejection fraction (LVEF), there were no significant differences in ultrasound parameters in the rest position. However, during the contraction of GM, the smaller the FL and Young's modulus, the larger the PA and EI with the increase of NYHA grade or the decrease of LVEF (P < 0.001).

Conclusion: The gray-scale US and SWE can provide an objective assessment of skeletal muscle status for CHF patients and are expected to be used to guide their early rehabilitation training and improve their prognosis.

Keywords: chronic heart failure; echo intensity; elastogarphy; muscle mass; ultrasound.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Photos of the rest position (A) and contraction position (B) under multimodal ultrasound examination. The extension of the foot's dorsum under the contraction position is indicated by the red arrow.
Figure 2
Figure 2
(A) Measurement of muscle fascicle length and PA by gray-scale ultrasound on the long axis of GM. The yellow dotted line indicates the deep aponeurosis of GM, and the yellow solid line indicates the muscle fascicle length. The angle between the muscle fascicle and the deep aponeurosis is PA. (B) EI analysis of GM muscle by using adobe Photoshop cc 2021 software. The mean gray value was shown in the histogram interface. (C) Measurement of the Young's modulus of GM.
Figure 3
Figure 3
Comparison of ultrasound parameters at different time points of the contraction position between control group and CHF group. *: compared with CHF group; the difference is statistically significant.
Figure 4
Figure 4
The boxplot graphic showed the changes in the ultrasound parameters over time for each NYHA subgroup of CHF group in the contraction position. P < 0.05 was considered a statistically difference. *: compared with NYHA I group; the difference is statistically significant. #: compared with NYHA II, the difference is statistically significant.
Figure 5
Figure 5
The boxplot graphic showed the changes in the ultrasound parameters over time for each LVEF subgroup of CHF group in the contraction position. P < 0.05 was considered a statistical difference. *: compared with HFpEF group, the difference is statistically significant. #: compared with HFmrEF, the difference is statistically significant.
See this image and copyright information in PMC

References

    1. Lena A, Anker MS, Springer J. Muscle wasting and sarcopenia in heart failure-the current state of science. Int J Mol Sci. (2020) 21(18):3–4. 10.3390/ijms21186549 - DOI - PMC - PubMed
    1. Philippou A, Barton ER. Optimizing IGF-I for skeletal muscle therapeutics. Growth Horm IGF Res. (2014) 24(5):157–63. 10.1016/j.ghir.2014.06.003 - DOI - PMC - PubMed
    1. Höllriegel R, Beck EB, Linke A, Adams V, Möbius-Winkler S, Mangner N, et al. Anabolic effects of exercise training in patients with advanced chronic heart failure (NYHA IIIb): impact on ubiquitin-protein ligases expression and skeletal muscle size. Int J Cardiol. (2013) 167(3):975–80. 10.1016/j.ijcard.2012.03.083 - DOI - PubMed
    1. Greising SM, Warren GL, Southern WM, Nichenko AS, Qualls AE, Corona BT, et al. Early rehabilitation for volumetric muscle loss injury augments endogenous regenerative aspects of muscle strength and oxidative capacity. BMC Musculoskelet Disord. (2018) 19(1):173. 10.1186/s12891-018-2095-6 - DOI - PMC - PubMed
    1. Yamada Y, Yamada M, Yoshida T, Miyachi M, Arai H. Validating muscle mass cutoffs of four international sarcopenia-working groups in Japanese people using DXA and BIA. J Cachexia Sarcopenia Muscle. (2021) 12(4):1000–10. 10.1002/jcsm.12732 - DOI - PMC - PubMed

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