Rui Valdiviesso1, Luís F Azevedo2, Emília Moreira3, Rosário Ataíde3, Sónia Martins4, Lia Fernandes5, José Silva-Cardoso6, Nuno Borges7. 1. Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Porto, Portugal; Centro de Investigação em Tecnologias e Serviços de Saúde, Faculdade de Medicina da Universidade do Porto, Porto, Portugal. Electronic address: valdiviesso@gmail.com. 2. Centro de Investigação em Tecnologias e Serviços de Saúde, Faculdade de Medicina da Universidade do Porto, Porto, Portugal; Departamento de Medicina da Comunidade, Informação e Decisão em Saúde, Faculdade de Medicina da Universidade do Porto, Porto, Portugal. 3. Centro de Investigação em Tecnologias e Serviços de Saúde, Faculdade de Medicina da Universidade do Porto, Porto, Portugal. 4. Centro de Investigação em Tecnologias e Serviços de Saúde, Faculdade de Medicina da Universidade do Porto, Porto, Portugal; Departamento de Neurociências Clínicas e Saúde Mental, Faculdade de Medicina da Universidade do Porto, Porto, Portugal. 5. Centro de Investigação em Tecnologias e Serviços de Saúde, Faculdade de Medicina da Universidade do Porto, Porto, Portugal; Departamento de Neurociências Clínicas e Saúde Mental, Faculdade de Medicina da Universidade do Porto, Porto, Portugal; Serviço de Psiquiatria do Centro Hospitalar Universitário de São João, Porto, Portugal. 6. Centro de Investigação em Tecnologias e Serviços de Saúde, Faculdade de Medicina da Universidade do Porto, Porto, Portugal; Departamento de Medicina, Faculdade de Medicina da Universidade do Porto, Porto, Portugal; Serviço de Cardiologia, Centro Hospitalar Universitário de São João, Porto, Portugal. 7. Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Porto, Portugal; Centro de Investigação em Tecnologias e Serviços de Saúde, Faculdade de Medicina da Universidade do Porto, Porto, Portugal.
Abstract
BACKGROUND AND AIM: Frailty phenotype (FP) is very common in heart failure (HF) and both syndromes worsen one another. The aim of this study is to first describe FP in a sample of Portuguese patients with HF, and to analyse its association with nutritional and clinical statuses, namely, muscle mass, obesity and functional class. METHODS AND RESULTS: In this cross-sectional study, a sample of 136 outpatients with HF (24-81 years, 33.8% women) were randomly selected from the appointments' listings of a HF and Transplant clinic in a Portuguese University Hospital. FP was assessed according to Fried et al. muscle mass was estimated from the mid-upper arm muscle circumference; weight status was assessed using the body mass index; HF functional classes were registered. The association between participants' characteristics and FP categories was analysed using logistic ordinal regression. The frequency of pre-frailty and frailty is 57.4% and 15.4%, respectively. Within frail individuals, 52.4% were under the age of 65. In multivariable analysis, frailty was positively associated with age 70 or older (OR = 3.44) and obesity (OR = 2.66), and negatively associated with muscle mass (OR = 0.77) and HF functional classes I (OR = 0.14) or II (OR = 0.29). CONCLUSION: Muscle mass seems to be an important predictor of frailty in patients with HF and should be taken into account when designing intervention plans that allow for reverting or modifying frailty and pre-frailty. Younger patients should be monitored for the presence and evolution of FP.
BACKGROUND AND AIM: Frailty phenotype (FP) is very common in heart failure (HF) and both syndromes worsen one another. The aim of this study is to first describe FP in a sample of Portuguese patients with HF, and to analyse its association with nutritional and clinical statuses, namely, muscle mass, obesity and functional class. METHODS AND RESULTS: In this cross-sectional study, a sample of 136 outpatients with HF (24-81 years, 33.8% women) were randomly selected from the appointments' listings of a HF and Transplant clinic in a Portuguese University Hospital. FP was assessed according to Fried et al. muscle mass was estimated from the mid-upper arm muscle circumference; weight status was assessed using the body mass index; HF functional classes were registered. The association between participants' characteristics and FP categories was analysed using logistic ordinal regression. The frequency of pre-frailty and frailty is 57.4% and 15.4%, respectively. Within frail individuals, 52.4% were under the age of 65. In multivariable analysis, frailty was positively associated with age 70 or older (OR = 3.44) and obesity (OR = 2.66), and negatively associated with muscle mass (OR = 0.77) and HF functional classes I (OR = 0.14) or II (OR = 0.29). CONCLUSION: Muscle mass seems to be an important predictor of frailty in patients with HF and should be taken into account when designing intervention plans that allow for reverting or modifying frailty and pre-frailty. Younger patients should be monitored for the presence and evolution of FP.