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. 2023 Oct;10(5):2982-2989.
doi: 10.1002/ehf2.14482. Epub 2023 Jul 31.

The association between erector spinae muscle content and chronic heart failure and its severity

Hao Zhang  1 , Weiwei Hu  1 , Mengxuan Yuan  2 , Dasheng Lu  3 , Yang Gao  2 , Qiming Dai  1
Affiliations

The association between erector spinae muscle content and chronic heart failure and its severity

Hao Zhang et al. ESC Heart Fail. 2023 Oct.

Abstract

Aims: Previous studies have shown a significant reduction in skeletal muscle content in patients with chronic heart failure (CHF). The present study focused on the erector spinae muscle (ESM) to determine whether ESM content is associated with the development and severity of CHF.

Methods and results: A total of 652 patients were included in this trial for the study. According to the diagnostic criteria of CHF, 652 patients were divided into two groups, namely, the control group (268 patients) and the CHF group (384 patients). Meanwhile, to assess whether the ESM is associated with the severity of CHF, patients in the CHF group were divided into two groups according to left ventricular ejection fraction (LVEF) values: heart failure with preserved ejection fraction (HFpEF, LVEF ≥50%, 256 patients) and heart failure with reduced ejection fraction (HFrEF, LVEF ≤40%, 68 patients). Receiver operating curve analysis was performed to assess whether ESM content could predict CHF and determine its severity. Compared with the control group, the patients in the CHF group were older, the prevalence of coronary heart disease (CHD) and atrial fibrillation was higher, the colour ultrasound results showed that LVEF decreased significantly, and the left ventricular end-diastolic internal diameter and left ventricular end-systolic internal diameter increased significantly. Besides, patients in the CHF group had significantly lower ESM content, and ESM is an independent predictor of heart failure, with an odds ratio of 0.713 (CHF group vs. control group, 95% confidence interval 0.626-0.811, P < 0.001). Compared with the HFpEF group, the HFrEF group has a lower prevalence of CHD, LVEF decreased significantly, the left ventricular end-diastolic internal diameter and left ventricular end-systolic internal diameter increased significantly, also patients in the HFrEF group had significantly lower ESM content compared with patients in the HFpEF group, and ESM is an independent predictor of the severity of heart failure, with an odds ratio of 0.514 (HFrEF group vs. HFpEF group, 95% confidence interval (0.418-0.633, P < 0.05). The results of receiver operating curve analysis showed that the sensitivity and specificity of ESM content for the diagnosis of CHF were 65.6% and 71.6%, respectively, while the sensitivity and specificity of ESM content for predicting the severity of CHF were 47.1% and 89.1%, respectively.

Conclusions: The ESM is of great value in predicting the onset and severity of CHF.

Keywords: Chronic heart failure; Erector spinae muscle; Sarcopenia; Skeletal muscle.

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Conflict of interest statement

All authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Schematic diagram of manual measurement of 12th thoracic vertebra horizontal erector spinae area using PACS system. (A) Manual measurement of left erector spinae area. (B) Manual measurement of left erector spinae area. (C) Sum of the area of the erector spinae muscles on both sides.
Figure 2
Figure 2
Value of ROC analysis of erector spinae for predicting chronic heart failure and its severity. (A) The role of erector spinae in predicting the onset of chronic heart failure; (B) The role of erector spinae in determining the severity of chronic heart failure. ROC, receiver operating curve.
See this image and copyright information in PMC

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