Sarcopenia in atrial fibrillation: a prospective study

TL;DR

This study shows that atrial fibrillation is associated with worse muscle health and quality of life, suggesting the need for muscle monitoring and nutrition strategies.

Contribution

The study is the first to prospectively link atrial fibrillation with sarcopenia indices using muscle ultrasonography and bioimpedance analysis.

Findings

AF is independently associated with lower hand grip strength and reduced phase angle.

AF patients show decreased muscle thickness and cross-sectional area in key muscle groups.

AF is linked to higher SARC-F scores and worse SarQol, indicating poorer muscle health and quality of life.

Abstract

The link between atrial fibrillation (AF) and lean body mass is unclear. This study presents the effects of AF on sarcopenia indices, including ultrasonographic muscle architecture.

In this study conducted in neurology units, 72 subjects with AF (mean age: 71 ± 11years, 49% female) were compared with 538 without AF (mean age:66±12years; 53% female) in terms of sarcopenia indices [anthropometry; Short Physical Performance Battery (SPPB); hand grip strength (HGS); bioimpedance analysis (BIA) indices; skeletal muscle mass index (SMMI) normalized to weight, height and body mass index (BMI); and phase angle (PhA)]; muscle ultrasonography [thickness, cross-section area (CSA), fiber length (fL) and pennation angle (PeA) of rectus femoris (RF), biceps brachii (BB), vastus lateralis (VL), vastus intermedius (VIM) and gastrocnemius medialis (GCM)]; possible causes of sarcopenia such as malnutrition; and consequences of sarcopenia [fall, fatigue, SarQol] along with sarcopenia screening (SARC-F). Possible associations were tested in multiple exploratory linear models, and partial r(pr) and p were reported.

Participants with AF exhibited significantly higher SARC-F and SarQol scores. In multivariable models adjusted for age, sex, height, and body weight, AF was independently linked to lower mean and maximum HGS (pr = −0.137, p = 0.014; pr = −0.130, p = 0.02), reduced PhA (pr = −0.193, p < 0.001), decreased RF thickness (pr = −0.120; p = 0.004), and diminished RF+VIM thickness (pr = −0.098; p = 0.019). Additional muscle ultrasound parameters, including BB-CSA, RF-CSA, BB-brachialis thickness, VL fL, and PeA and BIA indices, including SMMI(height), SMMI(weight), and SMMI(BMI), tended to be lower in AF.

AF is linked to impaired muscle health and reduced quality of life. Management should include thigh muscle ultrasound and strategies to prevent malnutrition.

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