Skeletal muscle atrophy is an independent prognostic predictor for patients with chronic
heart failure, and the concept of sarcopenia is drawing attention. Furthermore, the
importance of not only muscle mass but also ectopic fat has been pointed out. However,
there is a lack of consensus on the implications of ectopic fat for the prognosis
in patients with nonischemic cardiomyopathy. We investigated whether ectopic fat in
the thigh affects the prognosis of nonischemic cardiomyopathy. This prospective study
recruited 145 patients diagnosed with nonischemic cardiomyopathy between September
2017 and January 2020. Finally, 93 patients with a reduced ejection fraction were
enrolled. The clinical end points were cardiovascular death or unexpected rehospitalization
because of a cardiac event. Using computed tomography, the percentage of intramuscular
fat (%IMF) in the thigh was measured in all patients. Patients were divided into 2
groups based on the median %IMF. The results of Spearman's correlation coefficient
analysis revealed a correlation among %IMF and peak oxygen uptake (Spearman r = −0.221, p = 0.036). Kaplan-Meier analysis results showed significantly higher risk
of adverse events in the high %IMF group (log-rank p = 0.013). Multivariate Cox regression
analysis results revealed the %IMF as an independent factor for adverse events (hazard
ratio 1.361; 95% confidence interval 1.043 to 1.745; p = 0.018). In conclusion, %IMF
may have adverse consequences such as increased cardiac events in patients with nonischemic
cardiomyopathy with a reduced ejection fraction.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to American Journal of CardiologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Complementary role of arm circumference to body mass index in risk stratification in heart failure.JACC Heart Fail. 2016; 4: 265-273
- Intramuscular fat and inflammation differ in older adults: the impact of frailty and inactivity.J Nutr Health Aging. 2014; 18: 532-538
- Intramuscular adipose tissue attenuates gains in muscle quality in older adults at high risk for falling. A brief report.J Nutr Health Aging. 2013; 17: 215-218
- Plasma fibroblast growth factor 21 levels increase with ectopic fat accumulation and its receptor levels are decreased in the visceral fat of patients with type 2 diabetes.BMJ Open Diabetes Res Care. 2019; 7e000776
- Interplay between epicardial adipose tissue, metabolic and cardiovascular diseases.Clin Investig Arterioscler. 2018; 30: 230-239
- Epicardial adipose tissue thickness and its association with the presence and severity of coronary artery disease in clinical setting: a cross-sectional observational study.J Clin Med Res. 2016; 8: 410-419
- Is epicardial fat depot associated with atrial fibrillation? A systematic review and meta-analysis.Europace. 2017; 19: 747-752
- Collaborators developing the Japanese equation for estimated GFR. Revised equations for estimated GFR from serum creatinine in Japan.Am J Kidney Dis. 2009; 53: 982-992
- A new method for detecting anaerobic threshold by gas exchange.J Appl Physiol (1985). 1986; 60: 2020-2027
- Isometric knee muscle strength measurement using a belt-stabilized hand-held dynamometer and an isokinetic dynamometer with and without trunk fixation: investigation of agreement of measurement values and factors influencing measurement.J Phys Ther Sci. 2019; 31: 878-883
- Frailty may be a risk marker for adverse outcome in patients with congestive heart failure.ESC Heart Fail. 2015; 2: 168-170
- Impact of sarcopenia on prognosis in patients with heart failure with reduced and preserved ejection fraction.Eur J Prev Cardiol. 2021; 28: 1022-1029
- Increased intramuscular adipose tissue of the quadriceps is more strongly related to declines in ADL than is loss of muscle mass in older inpatients.Clin Nutr. 2021; 40: 1381-1387
- Muscle mass and intramuscular fat of the quadriceps are related to muscle strength in non-ambulatory chronic stroke survivors: a cross-sectional study.PLoS One. 2018; 13e0201789
- Loss of skeletal muscle mass predicts cardiac death in heart failure with a preserved ejection fraction but not heart failure with a reduced ejection fraction.ESC Heart Fail. 2020; 7: 4100-4107
- Nutritional supplementation with physical activity improves muscle composition in mobility-limited older adults, the VIVE2 study: a randomized, double-blind, placebo-controlled trial.J Gerontol A Biol Sci Med Sci. 2017; 73: 95-101
- Effects of 8 weeks of bed rest with or without resistance exercise intervention on the volume of the muscle tissue and the adipose tissues of the thigh.Physiol Rep. 2020; 8: e14560
- Effects of 10-week walking and walking with home-based resistance training on muscle quality, muscle size, and physical functional tests in healthy older individuals.Eur Rev Aging Phys Act. 2018; 15: 13
- Efficacy and safety of exercise training in patients with chronic heart failure: HF-ACTION randomized controlled trial.JAMA. 2009; 301: 1439-1450
- Cellular and molecular differences between HFpEF and HFrEF: a step ahead in an improved pathological understanding.Cells. 2020; 9: 242
- Body composition, natriuretic peptides, and adverse outcomes in heart failure with preserved and reduced ejection fraction.JACC Cardiovasc Imaging. 2021; 14: 203-215
- Regional adipose distribution and its relationship to exercise intolerance in older obese patients who have heart failure with preserved ejection fraction.JACC Heart Fail. 2018; 6: 640-649
Article Info
Publication History
Published online: January 20, 2022
Received in revised form:
December 18,
2021
Received:
November 10,
2021
Footnotes
This work was supported by a Grant-in-Aid for Young Scientists from the Japan Society for the Promotion of Science (A.S., 20K17091).
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
