Association between inflammation and skeletal muscle proteolysis, skeletal mass and strength in elderly heart failure patients and their prognostic implications
Abstract Background Inflammation and skeletal muscle wasting often coexist in elderly populations, but few studies have examined their relationship in elderly heart failure (HF) patients. This study examined the relationship between inflammation and increased skeletal muscle proteolysis, reduced ske...
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doaj-a041f920a06742a3a46646ed14b0f9f92020-11-25T01:19:49ZengBMCBMC Cardiovascular Disorders1471-22612020-05-012011910.1186/s12872-020-01514-0Association between inflammation and skeletal muscle proteolysis, skeletal mass and strength in elderly heart failure patients and their prognostic implicationsMasayuki Koshikawa0Masahide Harada1Shunsuke Noyama2Ken Kiyono3Yuji Motoike4Yoshihiro Nomura5Asuka Nishimura6Hideo Izawa7Eiichi Watanabe8Yukio Ozaki9Department of Cardiology, Fujita Health University School of MedicineDepartment of Cardiology, Fujita Health University School of MedicineDivision of Bioengineering, Graduate School of Engineering Science, Osaka UniversityDivision of Bioengineering, Graduate School of Engineering Science, Osaka UniversityDepartment of Cardiology, Fujita Health University School of MedicineDepartment of Cardiology, Fujita Health University School of MedicineDepartment of Cardiology, Fujita Health University School of MedicineDepartment of Cardiology, Fujita Health University School of Medicine, Bantane HospitalDepartment of Cardiology, Fujita Health University School of MedicineDepartment of Cardiology, Fujita Health University School of MedicineAbstract Background Inflammation and skeletal muscle wasting often coexist in elderly populations, but few studies have examined their relationship in elderly heart failure (HF) patients. This study examined the relationship between inflammation and increased skeletal muscle proteolysis, reduced skeletal mass and strength, and their prognostic implications in elderly HF patients (> 65 years) using a random forest approach. Methods We prospectively enrolled consecutive elderly HF patients (n = 78) and age- and sex-matched control subjects (n = 83). We measured the interleukin (IL)-6, C-reactive protein (CRP), and B-type natriuretic peptide (BNP) levels, lower limb muscle mass and strength, and 6-min walk distance. The amount of muscle proteolysis was determined by urinary 3-methylhystidine, normalized by creatinine (3-MH/Cr). The composite endpoint was defined as all-cause death or hospitalizations due to worsening HF. Results Compared to controls, elderly HF patients had a significantly higher IL-6, CRP, BNP, and 3-MH/Cr, and exhibited a reduced lower limb muscle mass and strength. A correlation analysis demonstrated significant positive correlations between the inflammatory cytokine levels and 3-MH/Cr and BNP, and negative correlations with the lower limb muscle mass and strength, and 6-min walk distance. During a median follow-up of 2.4-years, 24 patients reached the endpoint. A random forest model revealed that inflammatory cytokines, skeletal muscle wasting, and the BNP had greater effects on the risk prediction. The algorithm achieved an area under the receiver operating characteristic curve of 0.887 (95% CI, 0.772–1.000). Conclusion This study provided evidence of the association between inflammation and increased skeletal muscle proteolysis, reduced skeletal mass and strength, and their prognostic roles in elderly HF patients.http://link.springer.com/article/10.1186/s12872-020-01514-0ElderlySarcopeniaFrailtyMortality |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Masayuki Koshikawa Masahide Harada Shunsuke Noyama Ken Kiyono Yuji Motoike Yoshihiro Nomura Asuka Nishimura Hideo Izawa Eiichi Watanabe Yukio Ozaki |
spellingShingle |
Masayuki Koshikawa Masahide Harada Shunsuke Noyama Ken Kiyono Yuji Motoike Yoshihiro Nomura Asuka Nishimura Hideo Izawa Eiichi Watanabe Yukio Ozaki Association between inflammation and skeletal muscle proteolysis, skeletal mass and strength in elderly heart failure patients and their prognostic implications BMC Cardiovascular Disorders Elderly Sarcopenia Frailty Mortality |
author_facet |
Masayuki Koshikawa Masahide Harada Shunsuke Noyama Ken Kiyono Yuji Motoike Yoshihiro Nomura Asuka Nishimura Hideo Izawa Eiichi Watanabe Yukio Ozaki |
author_sort |
Masayuki Koshikawa |
title |
Association between inflammation and skeletal muscle proteolysis, skeletal mass and strength in elderly heart failure patients and their prognostic implications |
title_short |
Association between inflammation and skeletal muscle proteolysis, skeletal mass and strength in elderly heart failure patients and their prognostic implications |
title_full |
Association between inflammation and skeletal muscle proteolysis, skeletal mass and strength in elderly heart failure patients and their prognostic implications |
title_fullStr |
Association between inflammation and skeletal muscle proteolysis, skeletal mass and strength in elderly heart failure patients and their prognostic implications |
title_full_unstemmed |
Association between inflammation and skeletal muscle proteolysis, skeletal mass and strength in elderly heart failure patients and their prognostic implications |
title_sort |
association between inflammation and skeletal muscle proteolysis, skeletal mass and strength in elderly heart failure patients and their prognostic implications |
publisher |
BMC |
series |
BMC Cardiovascular Disorders |
issn |
1471-2261 |
publishDate |
2020-05-01 |
description |
Abstract Background Inflammation and skeletal muscle wasting often coexist in elderly populations, but few studies have examined their relationship in elderly heart failure (HF) patients. This study examined the relationship between inflammation and increased skeletal muscle proteolysis, reduced skeletal mass and strength, and their prognostic implications in elderly HF patients (> 65 years) using a random forest approach. Methods We prospectively enrolled consecutive elderly HF patients (n = 78) and age- and sex-matched control subjects (n = 83). We measured the interleukin (IL)-6, C-reactive protein (CRP), and B-type natriuretic peptide (BNP) levels, lower limb muscle mass and strength, and 6-min walk distance. The amount of muscle proteolysis was determined by urinary 3-methylhystidine, normalized by creatinine (3-MH/Cr). The composite endpoint was defined as all-cause death or hospitalizations due to worsening HF. Results Compared to controls, elderly HF patients had a significantly higher IL-6, CRP, BNP, and 3-MH/Cr, and exhibited a reduced lower limb muscle mass and strength. A correlation analysis demonstrated significant positive correlations between the inflammatory cytokine levels and 3-MH/Cr and BNP, and negative correlations with the lower limb muscle mass and strength, and 6-min walk distance. During a median follow-up of 2.4-years, 24 patients reached the endpoint. A random forest model revealed that inflammatory cytokines, skeletal muscle wasting, and the BNP had greater effects on the risk prediction. The algorithm achieved an area under the receiver operating characteristic curve of 0.887 (95% CI, 0.772–1.000). Conclusion This study provided evidence of the association between inflammation and increased skeletal muscle proteolysis, reduced skeletal mass and strength, and their prognostic roles in elderly HF patients. |
topic |
Elderly Sarcopenia Frailty Mortality |
url |
http://link.springer.com/article/10.1186/s12872-020-01514-0 |
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