Muscle wasting is associated with reduced exercise capacity and advanced disease in patients with chronic heart failure.

Muscle atrophy of the lower limbs is a comorbidity that can develop in advanced stages of chronic heart failure (HF). The article by Fülster et al. prospectively examined the association of muscle mass volume and muscle strength, gait speed, walking distance and treadmill performance in 200 stable HF patients. Muscle wasting was legitimately defined as the appendicular muscle mass two standard deviations below the mean of a healthy reference group. Muscle wasting was detected in 39 (19.5%) patients. Patients with muscle atrophy had significantly lower values for muscle strength, as well as lower total peak oxygen consumption (1173 ± 433 vs 1622 ± 456 ml/min), lower exercise time (7.7 ± 3.8 vs 10.2 ± 2.0 min; both p < 0.001) and lower left ventricular ejection fraction (p = 0.05). In addition, the distance walked and gait speed were also lower in patients with muscle wasting than those without (p < 0.05). Logistic regression analyses revealed that muscle wasting was independently associated with reduced peak oxygen consumption after adjustment for cofounders. These findings suggest that skeletal muscle wasting is common in chronic HF patients and is associated with worse exercise capacity and reduced left ventricular ejection fraction.