Prognostic value of ultrasound-assessed upper limb muscle thickness on mortality in older patients with heart failure: A post-hoc analysis of the SONIC-HF cohort study.

BACKGROUND AND AIMS: Upper limb muscle thickness assessed by ultrasound could be useful to estimate whole body muscle mass. We investigated the association between low upper limb muscle thickness and prognosis in older patients with heart failure (HF).

METHODS AND

RESULTS

This study was a post-hoc analysis of a prospective multicenter cohort, namely, the SONIC-HF study. Older (≥65 years) patients with HF were enrolled. Upper limb muscle thickness was assessed as biceps brachii and brachialis muscle thickness. The associations between upper limb muscle thickness stratified by sex-specific tertile and mortality were evaluated using survival analysis. Among the 606 eligible patients (median age, 81 years; 44.0 % female), 159 all-cause deaths (26.5 %) occurred during follow-up (median days, 735 days; 95 % confidence interval [CI], 458-882 days). Middle (adjusted hazard ratio [HR], 1.691; 95 % CI, 1.115-2.564; p = 0.014) and low upper limb muscle thickness group (HR, 1.882; 95 % CI, 1.231-2.793; p = 0.003) was associated with high all-cause mortality in older patients with HF compared to high upper limb muscle thickness group. The adjusted HRs for low upper limb muscle thickness in cardiovascular and non-cardiovascular deaths were 1.782 (95 % CI, 0.968-3.280; p = 0.063) and 1.917 (95 % CI, 1.098-3.347; p = 0.023), respectively. Higher upper limb muscle thickness was associated with reduced risk of sarcopenia (adjusted odds ratio, 0.902; 95 % CI, 0.859-0.947; p < 0.001).

CONCLUSIONS

Upper limb muscle thickness was correlated with mortality in older patients with HF. Ultrasound-based measurement is suggested to be valuable for their risk stratification.

CLINICAL TRIAL REGISTRATION: SONIC-HF was registered in UMIN-CTR (unique identifier: UMIN000031635).