natriuretic-peptide--brain and Sarcopenia

Screening questions for sarcopenia used in the community (SARC-F) may be regarded as indicators of exercise tolerance.. Observational study.. We tested the hypothesis that community-living older people who are screened positive for sarcopenia using the SARC-F tool but without a history of heart failure (HF) have a higher prevalence of cardiac abnormalities compared with those who are SARC-F negative.. Participants were recruited from a territory-wide primary care needs assessment for older people based in community centres, and from non-acute hospitals in the same region as the study centre.. Participants with a total score of >=4 and who did not have any history of HF were invited to attend for further cardiac assessment. Grip strength, walking speed, and the 6-minute walk test and echocardiography were carried out. Patients with frailty and at least Grade II diastolic dysfunction were considered to have heart failure with preserved ejection fraction (HFpEF) if they also had concomitant elevated N-terminal prohormone of B-type natriuretic peptide (NT-proBNP) of at least 300 pg/ml.. Diastolic dysfunction (DD) was significantly associated with SARC-F score >=4 and higher circulating NT-proBNP levels. ROC curves evaluating the predictive values of SARC-F, HGS and gait speed for DD showed that a combination of SARC-F and HGS or gait speed provided significant incremental value in predicting DD.. Community living older people with sarcopenia detected using a simple questionnaire have a higher prevalence of DD accompanied by elevated NT proBNP. Addition of hand grip strength or walking speed improve the magnitude of the association. SARC-F may be used as a tool to detect early cardiac dysfunction in the community.

Topics: Aged; Aged, 80 and over; Cardiovascular Diseases; Echocardiography; Female; Geriatric Assessment; Hand Strength; Humans; Male; Middle Aged; Natriuretic Peptide, Brain; Sarcopenia; Surveys and Questionnaires

To explore the association between sarcopenia (SAR) and long-term prognosis of patients with chronic heart failure (CHF) aged 70 years and over, 182 CHF patients from January 1, 2012 to December 31, 2014 were included in the present study. The patients were divided into the SAR group and the non-SAR group. The median follow-up period was 36 (3, 57) months. The endpoint was any heart failure-related event (HFRE). There were significant differences in age, body mass index, hemoglobin, B-type natriuretic peptide, hypersensitive troponin T (hs-TnT), left ventricular ejection fraction (LVEF) and cardiac function class between the two groups (all. 为观察肌少症对70岁及以上慢性心力衰竭（CHF）患者远期预后的影响，对年龄≥70岁的182例CHF患者进行为期至少2年的随访，根据患者是否存在肌少症分为肌少症组和非肌少症组，记录一般临床资料。终点事件为心力衰竭相关事件(HFRE)。结果2组间年龄、体重指数、血红蛋白、B型利钠肽、超敏肌钙蛋白T、左心室射血分数和纽约心脏病协会(NYHA)心功能分级差异有统计学意义（

Topics: Aged; Aged, 80 and over; Chronic Disease; Heart Failure; Humans; Kaplan-Meier Estimate; Multivariate Analysis; Natriuretic Peptide, Brain; Prognosis; Risk Factors; Sarcopenia; Severity of Illness Index; Troponin T; Ventricular Function, Left

Sarcopenia is frequently observed and associated with poor outcomes in patients with chronic kidney disease (CKD). A simple screening test for sarcopenia using age, grip strength, and calf circumference was recently developed. However, the clinical utility of this sarcopenia score in patients with CKD remains unclear.. We calculated the sarcopenia score of 265 patients with CKD and followed the patients for cardiovascular events. The endpoint of this study was the composite of cardiovascular hospitalization and total mortality. We divided all participants into high (n = 166) and low (n = 99) sarcopenia score groups using a simple scoring system. Patients in the high sarcopenia score group showed significantly higher plasma B-type natriuretic peptide (BNP) levels than those in the low sarcopenia score group (median: 103.1, interquartile range: 46.3-310.0 vs. 46.7, 18.0-91.8 pg/mL; p < 0.0001). The Kaplan-Meier curve revealed that the risk of cardiovascular events was significantly greater in the high sarcopenia score group (log-rank test: p < 0.0001), even after potential confounding factors were corrected using propensity score matching. Multivariate Cox hazard analysis identified a high sarcopenia score (hazard ratio: 3.04, 95% confidence interval: 1.45-6.38, p = 0.003) as an independent predictor of the primary endpoints. Furthermore, the combination of a high sarcopenia score and high BNP level identified patients with a significantly higher probability of future events (p < 0.0001).. This study demonstrates that this simple screening score for sarcopenia could be a useful tool for estimating the future adverse event risk in patients with CKD.

Topics: Aged; Aged, 80 and over; Biomarkers; Cardiovascular Diseases; Cohort Studies; Female; Follow-Up Studies; Forecasting; Glomerular Filtration Rate; Humans; Male; Middle Aged; Natriuretic Peptide, Brain; Predictive Value of Tests; Renal Insufficiency, Chronic; Risk Factors; Sarcopenia

To determine the pathogenic role of insulin resistance in the formation of involutive sarcopenia and chronic heart failure (CHF) were examined 88 elderly patients with arterial hypertension (AH) and 32 elderly patients without cardiovascular disease by methods of carbohydrate metabolism and the level of brain natriuretic peptide precursor evaluation, muscle mass and strength measuring, echocardiography, 6 minute walking test. It was found that in the group of hypertensive patients with low mass and muscle strength significantly increased indices of insulin resistance and more expressed signs of the left ventricle myocardial dysfunction and functional class of heart failure, probably as a result of disorders of energy homeostasis, resulting from the deterioration of glucose into the muscle cells of the heart and skeletal muscles.. Для определения патогенетической роли инсулинорезистентности и инволютивной саркопении в формировании миокардиальной дисфункции и хронической сердечной недостаточности (ХСН) при старении обследованы 88 больных пожилого возраста c артериальной гипертензией (АГ) и 32 пациента без сердечно-сосудистых заболеваний. Выполнена оценка показателей углеводного обмена, мышечной массы и силы, уровня предшественника мозгового натрийуретического пептида, эхокардиографического исследования, теста шестиминутной ходьбы. Установлено, что у больных АГ с низким содержанием мышечной ткани и силы мышц достоверно повышены показатели инсулинорезистентности, более выражены признаки дисфункции миокарда ЛЖ и ФК ХСН. Одной из вероятных причин указанных патологических состояний служат нарушения энергетического гомеостаза, обусловленные ухудшением поступления глюкозы в мышечные клетки сердца и скелетной мускулатуры.

Topics: Aged; Carbohydrate Metabolism; Echocardiography; Energy Metabolism; Female; Heart Failure; Humans; Hypertension; Insulin Resistance; Male; Muscle Strength; Muscle, Skeletal; Natriuretic Peptide, Brain; Sarcopenia; Statistics as Topic; Walk Test

Progressive loss of skeletal muscle termed "sarcopenia" is an independent risk factor for mortality in patients with cardiovascular diseases. A simple screening test that can identify sarcopenia using three variables (age, grip strength and calf circumference) was recently developed. We evaluated the clinical utility of this screening test in patients with heart failure (HF).. HF patients were divided into the sarcopenia (n=82) and non-sarcopenia (n=37) groups based on the sarcopenia score. Circulating BNP and high-sensitive cardiac troponin T levels were significantly higher, and left ventricular ejection fraction was lower in the sarcopenia group than non-sarcopenia group. Kaplan-Meier curve showed that HF event-free survival rate was significantly lower in the sarcopenia group. Multivariate Cox proportional hazards analysis identified BNP (ln[BNP]) (hazard ratio [HR]: 1.58; 95% CI: 1.09-2.29, p=0.02), hs-CRP (ln[CRP]) (HR: 1.82; 95% CI: 1.23-2.68; p<0.01) and sarcopenia score (HR: 1.03; 95% CI: 1.01-1.05, p<0.01) as independent predictors of HF events. In receiver operating characteristic analysis, adding the sarcopenia score to BNP levels increased an area under the curve for future HF events (sarcopenia score alone, 0.77; BNP alone, 0.82; combination, 0.89).. The sarcopenia screening test can be used to predict future adverse events in patients with HF.

Topics: Aged; Aged, 80 and over; Early Diagnosis; Female; Heart Failure; Heart Ventricles; Humans; Kaplan-Meier Estimate; Male; Natriuretic Peptide, Brain; Risk Factors; ROC Curve; Sarcopenia; Stroke Volume; Survival Analysis; Troponin T

Frailty, a geriatric syndrome reflecting a state of reduced physiological reserve and increased vulnerability, is an independent risk factor for cardiovascular morbidity and mortality. However, the relationship between frailty and hypertensive end-organ damage is not fully established.. We performed a cross-sectional study to investigate the association between frailty and end-organ damage in 1125 apparently healthy middle-aged to elderly subjects. We performed a simple frailty (SF) score that was easily obtainable in the office, in combination with low hand grip power and short one-leg standing (OLS) time. The association between SF score and hypertensive end-organ damage and other frailty-related parameters was evaluated. Odds ratio of SF score 1 to score 0 for the presence of hypertension was 1.9 [1.4-2.5, p<.0001] and that of SF score 2 was 3.3 [2.1-5.3, p<.0001]. SF score was also significantly associated with brachial-ankle pulse wave velocity (baPWV) and central pulse pressure (PP2). SF score was significantly associated with higher frailty index calculated from 21 parameters, lower cognitive test score, % vital capacity, skeletal muscle mass, and thigh muscle cross-sectional area. SF score was positively associated with stage of brain white matter hyperintenisty, plasma levels of B-type natriuretic peptide, and urinary protein excretion, even after correction for confounding parameters including baPWV and PP2.. These findings indicate that frailty is significantly associated with end-organ damage in elderly subjects. SF score may be a useful clinical tool to identify frail subjects and advanced end-organ damage in elderly subjects.

Topics: Aged; Aged, 80 and over; Ankle Brachial Index; Cross-Sectional Studies; Female; Frail Elderly; Geriatric Assessment; Hand Strength; Humans; Hypertension; Male; Middle Aged; Muscle, Skeletal; Natriuretic Peptide, Brain; Odds Ratio; Sarcopenia; White Matter