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  • 1
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    Online Resource
    Does renin‐angiotensin system inhibition have impacts on muscle mass and bone mineral density in heart failure patients?
    Wiley ; 2021
    In:  ESC Heart Failure Vol. 8, No. 4 ( 2021-08), p. 2617-2624
    Details
    In: ESC Heart Failure, Wiley, Vol. 8, No. 4 ( 2021-08), p. 2617-2624
    Abstract: Results of experimental studies have indicated the possibility of muscle and bone mass being negatively regulated by renin‐angiotensin system (RAS) activation, but that possibility has not been analysed in patients with heart failure (HF). Methods and results Data for HF patients who received a dual‐energy X‐ray absorptiometry scan in our hospital were reviewed. Propensity scores for the use of RAS inhibitors (RASIs) were calculated using a multivariate logistic regression model to minimize selection bias. One hundred sixty pairs of patients were extracted. Plasma aldosterone concentration was significantly lower in the RASIs group than in the no‐RASIs group (119 [IQR 71–185] vs. 94 [IQR 60–131] pg/mL, P  = 0.003), confirming RAS inhibition in the RASIs group. Skeletal muscle mass index tended to be higher in the RASIs group than in the non‐RASIs group (15.6 [IQR 14.0–17.2] vs. 15.0 [IQR 13.3–16.6] pg/mL, P  = 0.065). The proportion of patients with muscle wasting, defined as appendicular skeletal muscle mass indexes of 〈 7.00 and 〈 5.40 kg/m 2 for males and females, respectively, was significantly lower in the RASIs group than in the non‐RASIs group (53% vs. 64%, P  = 0.041). Multivariate logistic regression analysis showed that the no use of RASIs was associated with presence of muscle wasting independently of age, presence of diabetes, renal function, and severity of HF. Bone mineral densities and proportions of patients with osteoporosis were similar in the two groups. Conclusions Renin‐angiotensin system inhibition is associated with a lower prevalence of muscle wasting in HF patients independently of established risk factors.
    Type of Medium: Online Resource
    ISSN: 2055-5822 , 2055-5822
    URL: Issue
    URL: Article
    DOI: 10.1002/ehf2.v8.4
    DOI: 10.1002/ehf2.13430
    Language: English
    Publisher: Wiley
    Publication Date: 2021
    detail.hit.zdb_id: 2814355-3
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  • 2
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    Independent link between peripheral artery disease and muscle wasting in patients with heart failure
    Wiley ; 2020
    In:  ESC Heart Failure Vol. 7, No. 5 ( 2020-10), p. 3252-3256
    Details
    In: ESC Heart Failure, Wiley, Vol. 7, No. 5 ( 2020-10), p. 3252-3256
    Abstract: A high prevalence of muscle wasting, that is, reduction in muscle mass, in patients with peripheral artery disease (PAD) and heart failure (HF) has been reported. However, whether the association between PAD and muscle wasting is independent of shared risk factors such as diabetes mellitus has not been examined. Methods and results We retrospectively enrolled 440 HF patients (mean age, 74 years; inter‐quartile range, 64–82 years; 52% male). Muscle wasting was defined as an appendicular skeletal muscle mass index (ASMI) of 〈 7.0 kg/m 2 in men and 〈 5.4 kg/m 2 in women. PAD was defined as an ankle brachial index (ABI) of 〈 0.9 in either leg. The prevalence of PAD in HF patients was 21%. ASMI was positively correlated with ABI in HF patients. In multivariate logistic regression analysis, ASMI and muscle wasting were selected as independent explanatory factors of the presence of PAD after adjustment for age, sex, diabetes mellitus, hypertension, dyslipidaemia, estimated glomerular filtration rate, and smoking status, established risk factors of atherosclerosis. In propensity score‐matched analysis, frequency of muscle wasting was higher in patients with PAD than in patients with an ABI of ≧1.1 (72.1% vs. 52.5%, P  = 0.04). Conclusions The results suggest that there is an independent link between PAD and muscle wasting in HF patients.
    Type of Medium: Online Resource
    ISSN: 2055-5822 , 2055-5822
    URL: Issue
    URL: Article
    DOI: 10.1002/ehf2.v7.5
    DOI: 10.1002/ehf2.12951
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 2814355-3
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  • 3
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    Distinct determinants of muscle wasting in nonobese heart failure patients with and without type 2 diabetes mellitus
    Wiley ; 2021
    In:  Journal of Diabetes Vol. 13, No. 1 ( 2021-01), p. 7-18
    Details
    In: Journal of Diabetes, Wiley, Vol. 13, No. 1 ( 2021-01), p. 7-18
    Abstract: 慢性心力衰竭(chronic heart failure, CHF)和糖尿病(diabetes mellitus, DM)患者常出现肌肉萎缩, 即肌肉质量减少。 方法 我们回顾了185例CHF患者[中位年龄71岁(四分位数范围61~78岁), 其中64%为男性], 他们接受了双能X线骨密度仪扫描以评估全身四肢骨骼肌质量指数(appendicular skeletal muscle mass index, ASMI)。 结果 70例CHF患者(38%)合并DM。与非糖尿病患者相比, 糖尿病患者缺血性心脏病和高血压的患病率更高, 肾小球滤过率(estimated glomerular filtration rate, eGFR)和ASMI水平更低, 血浆肾素活性(plasma renin activity, PRA)水平更高。在简单回归分析中, ASMI与MNA‐SF(微型营养评估简表)评分、血红蛋白、eGFR和空腹血浆胰岛素水平呈正相关, 与N端B型利钠肽原、PRA和皮质醇水平呈负相关。多元线性回归分析显示, 年龄、MNA‐SF评分、糖尿病、空腹血浆胰岛素水平和PRA与ASMI独立相关。在非糖尿病组和糖尿病组分别进行多元线性回归分析时, MNA‐SF评分和空腹血浆胰岛素水平是两组ASMI的独立变量。在糖尿病组中, PRA与ASMI独立相关, 而在非糖尿病组中, 皮质醇浓度与ASMI无关, 而皮质醇浓度仅在非糖尿病组中与ASMI独立相关。 结论 除了营养不良和血浆胰岛素降低外, 肾素‐血管紧张素系统激活可能是心力衰竭合并糖尿病患者肌肉萎缩的原因。
    Type of Medium: Online Resource
    ISSN: 1753-0393 , 1753-0407
    URL: Issue
    URL: Article
    DOI: 10.1111/jdb.v13.1
    DOI: 10.1111/1753-0407.13090
    Language: English
    Publisher: Wiley
    Publication Date: 2021
    detail.hit.zdb_id: 2485432-3
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  • 4
    Online Resource
    Online Resource
    Plasma amino acid profiling improves predictive accuracy of adverse events in patients with heart failure
    Wiley ; 2021
    In:  ESC Heart Failure Vol. 8, No. 6 ( 2021-12), p. 5045-5056
    Details
    In: ESC Heart Failure, Wiley, Vol. 8, No. 6 ( 2021-12), p. 5045-5056
    Abstract: The clinical outcome of heart failure (HF) is complicated by the presence of multiple comorbidities including malnutrition and cachexia, and prediction of the outcome is still difficult in each patient. Metabolomics including amino acid profiling enables detection of alterations in whole body metabolism. The aim of this study was to determine whether plasma amino acid profiling improves prediction of clinical outcomes in patients with HF. Methods and results We retrospectively examined 301 HF patients (70 ± 15 years old; 59% male). Blood samples for measurements of amino acid concentrations were collected in a fasting state after stabilization of HF. Plasma amino acid concentrations were measured using ultraperformance liquid chromatography. Clinical endpoint of this study was adverse event defined as all‐cause death and unscheduled readmission due to worsening HF or lethal arrhythmia. During a mean follow‐up period of 380 ± 214 days, 40 patients (13%) had adverse events. Results of analyses of variable importance in projection score, a measure of a variable's importance in partial least squares–discriminant analysis (PLS‐DA) showed that the top five amino acids being associated with adverse events were 3‐methylhistidine (3‐Me‐His), β‐alanine, valine, hydroxyproline, and tryptophan. Multivariate Cox‐proportional hazard analyses indicated that a high 3‐Me‐His concentration and low β‐alanine and valine concentrations were independently associated with adverse events. When HF patients were divided according to the cut‐off values of amino acids calculated from receiver operating characteristic curves, Kaplan–Meier survival curves showed that event‐free survival rates were lower in HF patients with high 3‐Me‐His than in HF patients with low 3‐Me‐His (68% vs. 91%, P   〈  0.01). In a subgroup with high 3‐Me‐His, HF patients with low β‐alanine and those with low valine had significantly lower event‐free survival rates than did HF patients with high β‐alanine and those with high valine, respectively. On the other hand, Kaplan–Meier curves of event‐free survival rates did not differ between HF patients with and those without low β‐alanine and low valine in subgroups of patients with low 3‐Me‐His. Inclusion of both high 3‐Me‐His and low β‐alanine or low valine into the adjustment model including N‐terminal pro‐brain natriuretic peptide improved the accuracy of prediction of adverse events after discharge. 3‐Me‐His concentration was associated with muscle mass and nutritional status. Conclusions Simple measurement of 3‐Me‐His with either β‐alanine or valine improved the predictive ability for adverse events, indicating the utility of plasma amino acid profiling in risk stratification of hospitalized HF patients.
    Type of Medium: Online Resource
    ISSN: 2055-5822 , 2055-5822
    URL: Issue
    URL: Article
    DOI: 10.1002/ehf2.v8.6
    DOI: 10.1002/ehf2.13572
    Language: English
    Publisher: Wiley
    Publication Date: 2021
    detail.hit.zdb_id: 2814355-3
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