Sarcopenia in atrial fibrillation: a prospective study

Abstract

Background/aim: 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. Materials and methods: 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. Results: 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. Conclusion: AF is linked to impaired muscle health and reduced quality of life. Management should include thigh muscle ultrasound and strategies to prevent malnutrition.