Shota Uchida1, Kentaro Kamiya2, Nobuaki Hamazaki3, Kohei Nozaki3, Takafumi Ichikawa3, Takeshi Nakamura1, Masashi Yamashita1, Emi Maekawa4, Jennifer L Reed5, Minako Yamaoka-Tojo6, Atsuhiko Matsunaga6, Junya Ako4. 1. Department of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan. 2. Department of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan; Department of Rehabilitation, Kitasato University School of Allied Health Sciences, Sagamihara, Japan. Electronic address: k-kamiya@kitasato-u.ac.jp. 3. Department of Rehabilitation, Kitasato University Hospital, Sagamihara, Japan. 4. Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan. 5. Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Canada; Faculty of Medicine, University of Ottawa, Canada; School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Canada. 6. Department of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan; Department of Rehabilitation, Kitasato University School of Allied Health Sciences, Sagamihara, Japan.
Abstract
BACKGROUND: Dynapenia, defined as age-associated loss of skeletal muscle strength, is associated with increased mortality rate, poor activities of daily living, and reduced quality of life. Therefore, dynapenia appears to be a better independent predictor of mortality than sarcopenia in the elderly. However, the prognostic utility of dynapenia in patients with cardiovascular disease (CVD) is not clear. This study was performed to examine the prognostic utility of dynapenia defined by the criteria of Manini et al. in patients with CVD. METHODS: The findings of 4192 consecutive patients ≥30 years old (median [interquartile range (IQR)] age 69 [60-76] years, 2874 males) with CVD were reviewed. Grip strength and quadriceps isometric strength (QIS) were measured just before hospital discharge, and low grip strength (<26 kg in males and <18 kg in females), low QIS (<45.0% body mass [BM] and <35.0% BM in males and females, respectively) were considered to indicate dynapenia. The endpoint was all-cause mortality. RESULTS: A total of 507 deaths occurred during follow-up (median 2.0 years, IQR 0.8-4.4 years). The overall prevalence of dynapenia was 33.6% and increased with age (p for trend < 0.01). Females showed a significantly higher prevalence rate of dynapenia than males (43.3% vs. 29.2%, respectively; p < 0.01). Patients with dynapenia showed higher all-cause mortality rate than non-dynapenia patients (adjusted hazard ratio: 1.84; 95% confidence interval: 1.51-2.23; p < 0.01). CONCLUSIONS: Dynapenia has a high prevalence among patients with CVD and is associated with increased mortality rate.
BACKGROUND: Dynapenia, defined as age-associated loss of skeletal muscle strength, is associated with increased mortality rate, poor activities of daily living, and reduced quality of life. Therefore, dynapenia appears to be a better independent predictor of mortality than sarcopenia in the elderly. However, the prognostic utility of dynapenia in patients with cardiovascular disease (CVD) is not clear. This study was performed to examine the prognostic utility of dynapenia defined by the criteria of Manini et al. in patients with CVD. METHODS: The findings of 4192 consecutive patients ≥30 years old (median [interquartile range (IQR)] age 69 [60-76] years, 2874 males) with CVD were reviewed. Grip strength and quadriceps isometric strength (QIS) were measured just before hospital discharge, and low grip strength (<26 kg in males and <18 kg in females), low QIS (<45.0% body mass [BM] and <35.0% BM in males and females, respectively) were considered to indicate dynapenia. The endpoint was all-cause mortality. RESULTS: A total of 507 deaths occurred during follow-up (median 2.0 years, IQR 0.8-4.4 years). The overall prevalence of dynapenia was 33.6% and increased with age (p for trend < 0.01). Females showed a significantly higher prevalence rate of dynapenia than males (43.3% vs. 29.2%, respectively; p < 0.01). Patients with dynapenia showed higher all-cause mortality rate than non-dynapeniapatients (adjusted hazard ratio: 1.84; 95% confidence interval: 1.51-2.23; p < 0.01). CONCLUSIONS: Dynapenia has a high prevalence among patients with CVD and is associated with increased mortality rate.
Authors: Zheng-Yii Lee; Cindy Sing Ling Yap; M Shahnaz Hasan; Julia Patrick Engkasan; Mohd Yusof Barakatun-Nisak; Andrew G Day; Jayshil J Patel; Daren K Heyland Journal: Crit Care Date: 2021-07-23 Impact factor: 9.097