Decreased Muscle Strength and Quality as Characteristics of Elderly Heart Failure and Hip Fractures in Patients with Sarcopenia

Background/Purpose: The prevalence of sarcopenia is high in patients with medical diseases and after fractures and is particularly high in heart failure patients among patients with medical diseases and hip fracture patients among patients with fractures. In 2019, the European Working Group of Sarcopenia in Older People 2 reported that muscle quality assessment is important for the diagnosis of sarcopenia. However, it is unknown whether sarcopenia in heart failure and hip fracture patients is significantly associated with poor muscle quality. This study aimed to determine whether muscle quality is associated with sarcopenia in heart failure and hip fracture patients. Methods: Basic medical information, extracellular water (ECW) / intracellular water (ICW) ratio as muscle quality, and physical functions were assessed. Hierarchical multinomial logistic regression analysis was performed to investigate factors associated with three groups (i.e., healthy elderly participants, patients with heart failure and sarcopenia, and patients with hip fracture and sarcopenia). Results: Participants included in the analysis were 21 healthy elderly participants, 15 in patients with heart failure and sarcopenia, and 21 in patients with hip fracture and sarcopenia. The results of hierarchical multinomial logistic regression analysis revealed that high total ECW/ICW ratio was a significant predictor for sarcopenia in patients with heart failure and hip fracture. The odds ratios for total ECW/ICW ratio were 11.47 in patients with heart failure and sarcopenia and 30.91 in patients with hip fracture and sarcopenia, respectively. Conclusion: This study suggested that poor muscle quality were associated with sarcopenia in patients with heart failure and hip fracture.