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Simple Sarcopenia Screening Test Found to Predict Heart Failure Severity

By LabMedica International staff writers
Posted on 31 May 2016
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Image: Brain Natriuretic Peptide (BNP) levels in patients with and without sarcopenia. Risk of heart failure is higher in patients with sarcopenia (Photo courtesy of Dr. Yasuhiro Izumiya).
Image: Brain Natriuretic Peptide (BNP) levels in patients with and without sarcopenia. Risk of heart failure is higher in patients with sarcopenia (Photo courtesy of Dr. Yasuhiro Izumiya).
Researchers have shown that the simple screening method originally developed to diagnose sarcopenia can be used, instead of CT or MRI, to quickly and easily predict severity of heart failure disease. They also found that the predictive capabilities of the brain natriuretic peptide (BNP) lab test for heart function can be further improved if coupled with a patient's sarcopenia test score.

People naturally have varying degrees of loss of muscle mass and strength as they age, but a large loss such (as in sarcopenia and muscle-wasting diseases such as chronic kidney disease, diabetes mellitus, and chronic obstructive pulmonary disease) can be detrimental especially for patients of cancer or heart disease. The reasons for the exacerbated pathology of cancer or heart disease when combined with sarcopenia are not yet clear. It is thought that skeletal muscle (whose primary function is movement) may secrete a substance that improves the condition of remote organs, and when skeletal muscle mass is decreased this substance also decreases.

Pathogenesis of sarcopenia, particularly in elderly patients, should be assessed carefully. Traditionally, tests to diagnose sarcopenia were often difficult since muscle-mass measurements were taken with CT or MRI examinations, which are expensive and not available at all medical institutions.

Recently, a sarcopenia screening test was developed that does not require expensive equipment. This quick and simple test calculates a patient's "sarcopenia score" by using age, grip strength, and calf circumference.

In order to determine if this screening test is also effective at evaluating patients with heart failure, a research team from Kumamoto University (Kumamoto, Japan) studied 119 patients hospitalized for evaluation and treatment of heart failure. The team calculated sarcopenia scores prior to discharge and compared the scores to laboratory data, echocardiography, and the patient's prognosis over a 750-day period.

The results showed that higher sarcopenia scores were related to higher levels of brain natriuretic peptide (BNP; hormone marker for heart function) and to the left ventricular ejection fraction (which indicates how well the heart pumps blood during ventricular contraction). Continued examination – of each patient's progress, re-hospitalization, and mortality due to heart failure – found that patients with higher sarcopenia scores were at a higher risk of heart failure.

Evaluation of BNP levels is useful to predict prognosis of heart failure patients. The predictive capabilities of BNP assessment can be further improved if coupled with a patient's sarcopenia score. The sarcopenia screening test in evaluation of heart failure severity can be easily and effectively employed in a daily clinical setting at any medical institution.

The study, by Onoue Y et al, was published online April 17, 2016, in the International Journal of Cardiology.

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