The value of ultrasound of muscle tissue for assessing body composition phenotypes in patients with heart failure

Introduction

Sarcopenia/sarcopenic obesity is a significant problem in patients with chronic heart failure (CHF) due to its increasing prevalence and poorer outcomes. Since ultrasound is cheaper, more mobile, and more accessible than other methods (for example, bioimpedance analysis of body composition, BIA), it has the potential for widespread use as a clinical screening tool to identify patients with CHF and sarcopenic obesity.

Aim

The aim of the study was to determine the value of ultrasound of muscle tissue in addition to BIA for determining body composition phenotypes in patients with CHF.

Materials and methods

50 patients, average age 72.5±6.9 years, who were hospitalized for CHF decompensation, 53.8% (n=27) male, were prospectively included. In addition to traditional laboratory and instrumental studies, all patients underwent bioimpedance analysis of body composition (BIA) and ultrasound of vastus lateralis muscle tissue after hemodynamic stabilization (on day 5-7 of hospitalization), and the risk of sarcopenia was determined according to EWGSOP2 criteria. On a sagittal ultrasound image of the vastus lateralis muscle obtained at the distal 35% of femur length, the fascicle length, the muscle thickness, and the pennation angle were measured.

Results

In the included cohort of patients, preserved left ventricular ejection fraction (LVEF) was the most common (63.2%), moderately reduced LVEF was observed in 17.2%, and low LVEF was observed in 19.6%.

The average thickness of the vastus lateralis muscle tissue in patients with CHF was 1.3±0.3 cm (below normal), the penation angle was 15.9±4.6⁰ (below normal). According to the BIA, according to the EWGSOP2 criteria, a decrease in muscle mass corresponding to sarcopenia/sarcopenic obesity was observed in 18.2% of patients.

There was a moderate correlation when comparing the thickness of muscle tissue and the pennation angle with the musculoskeletal mass according to the BIA (r=0.410, p<0.05 and r=0.529, p<0.01, respectively). The renation angle correlated with the presence of excess extracellular fluid in patients with CHF (r=0.520, p<0.01). In addition, the thickness of the muscle tissue was highly correlated with the penation angle (r=0.737, p<0.001).

In our cohort of patients, there were no differences in hospital outcomes (death from any cause, duration of hospitalization) in the presence of sarcopenia.

Conclusion

The results of ultrasound of muscle tissue were highly correlated with BIA for the diagnosis of a decrease in musculoskeletal mass, thus, ultrasound of muscle tissue is a reliable and reproducible ultrasound method for the diagnosis of loss of muscle mass associated with sarcopenia in patients with CHF.