Reduced thoracic skeletal muscle size is associated with adverse outcomes in diabetes patients with heart failure and reduced ejection fraction: quantitative analysis of sarcopenia by using cardiac MRI
Main finding · Adverse outcomesResult — go to the resultHazard ratio 0.96 95% CI 0.92–0.99Authors' conclusion
With respect to diabetes patients with HFrEF, thoracic SMI is a novel alternative for evaluating muscle wasting in sarcopenia that can be obtained by a readily available routine cardiac MRI protocol. A reduction in thoracic skeletal muscle size predicts poor outcomes in the context of DM with HFrEF.
Study context
- Population
- Diabetes mellitus (DM) patients with heart failure with reduced ejection fraction (HFrEF)
- Participants
- 243 patients
- Exposure
- Thoracic skeletal muscle index (SMI) tertiles; association with left ventricular (LV) remodeling, NT-proBNP and adverse outcomes
- Outcome
- Adverse outcomes
- Follow-up
- Median 33.6 months (IQR, 20.4-52.8 months)
Methodological detailscardiac MRI, tertiles of thoracic SMI, multivariable Cox proportional hazards model
- Cardiac MRI
- Tertiles of thoracic SMI
- Multivariable Cox proportional hazards model
Main finding
As reported in the abstract
median follow-up 33.6 months
Hazard ratio
0.96
95% CI 0.92–0.99
P = 0.01
By group
Higher thoracic SMI
HR 0.96 (95% CI 0.92–0.99); P = 0.01
- Lower thoracic SMI in patients with vs without adverse outcomes
- P < 0.05
- Similar BMI in patients with vs without adverse outcomes
- P = 0.76
Observational data: associations, not effects.
Further findings
LV remodeling by thoracic SMI tertile
- Lowest SMI tertile: worse LV systolic strain in three components, higher LV mass, heavier myocardial fibrosis
- all P < 0.05
Determinants of NT-proBNP (linear regression)
- Thoracic SMI independently associated with NT-proBNP
- β = −0.25; P < 0.001
- BMI
- β = −0.04; P = 0.55
Original publication
Reduced thoracic skeletal muscle size is associated with adverse outcomes in diabetes patients with heart failure and reduced ejection fraction: quantitative analysis of sarcopenia by using cardiac MRI. Cardiovasc Diabetol. Published 13 January 2024. doi:10.
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