A systematic review of sarcopenia in heart failure

Abstract

Background: Sarcopenia, a progressive loss of muscle mass and strength, is a prevalent comorbidity in heart failure (HF) and significantly impacts patients' functional capacity, quality of life, and clinical outcomes. Understanding its prevalence and implications in HF is crucial for developing targeted management strategies.
Objective: This systematic review aims to assess the prevalence of sarcopenia in HF, examine its diagnostic criteria, and evaluate its associations with demographic, functional, and clinical outcomes.
Methods: A systematic search was conducted across multiple databases (e.g., PubMed, MEDLINE, EMBASE) following PRISMA guidelines. Observational studies assessing sarcopenia in HF populations using standardized diagnostic criteria were included. Data extraction focused on prevalence, demographic characteristics, diagnostic tools, and clinical outcomes.
Results: Sarcopenia was identified as a common comorbidity in HF, with substantial variability in prevalence depending on diagnostic criteria and patient characteristics. Studies employing tools such as dual-energy X-ray absorptiometry (DXA) and the European Working Group on Sarcopenia in Older People (EWGSOP) criteria reported a higher prevalence compared to other methods. Sarcopenia was more frequent in older patients and males and was associated with worse functional outcomes, including reduced exercise capacity, muscle strength, and quality of life.
Conclusions: Sarcopenia is a prevalent and underrecognized condition in HF populations, contributing to poor clinical outcomes. Standardizing diagnostic criteria and integrating routine sarcopenia screening into HF care are essential for improving patient management and outcomes. Future research should focus on longitudinal studies and the efficacy of combined therapeutic approaches, including exercise, nutritional support, and pharmacological interventions.