Abstract 12690: Psoas Muscle Area as a Novel Index of Sarcopenia Predicts Early Clinical Adverse Events in Patients With Heart Failure

IntroductionHeart failure (HF) has become huge socioeconomic burden and HF patients who were repeatedly hospitalized due to acute decompensated HF (ADHF) have become a priority theme, often referred to as “frequent flyer”. Accumulating evidence suggest that sarcopenia has a negative impact on clinical outcome in general population. However, its prognostic significance in HF has not yet been fully investigated because of various approaches or cut-off values employed for its definition. We sought to determine the significance of psoas muscle area (PMA) measured by computed tomography as a novel index of sarcopenia in patients with ADHF.MethodsIn this single-center retrospective observational study, we reviewed consecutive 823 subjects who required hospitalization due to ADHF and 459 were available for analysis (75±12 years, 61% male). Cross-sectional areas of PMA at the level of fourth lumbar vertebra were measured by computed tomography and normalized to body surface area (PMA/BSA).ResultsWhen the patients were divided into lower and higher PMA/BSA groups according to the median value (414 mm/m), lower PMA/BSA was associated with older age and higher proportion of female. Multiple regression analysis revealed age, gender, BMI, hemoglobin level and E/e’, but not LVEF, were independently associated with PMA/BSA. Lower PMA/BSA was associated with higher rate of composite endpoint of all-cause death and ADHF re-hospitalization during short-term (90 days, P=0.03) and long-term (2 years, P=0.02) follow-up. Multivariate Cox proportional hazards analysis identified PMA/BSA, but not BMI, as an independent predictor of composite endpoint during 90 days follow up (hazard ratio :1.004; 95% CI:1.001-1.007, P=0.02).ConclusionIn patients hospitalized for ADHF, PMA predicted early adverse events. These findings suggest the possibility that intervention for sarcopenia might benefit frequent flyers.