Low Muscle Strength Assessed with Dynamometry in Elderly Polypathological Patients with Acute Heart Failure: PROFUND-IC Registry
Abstract
:1. Introduction
2. Methods
2.1. Study Design
2.2. Population Study
The Inclusion Criteria Are
- ▪
- Age over 18 years.
- ▪
- Have a primary diagnosis of acute heart failure (HF) as the reason for admission, including episodes of de novo HF and decompensation of chronic heart failure.
- ▪
- NTproBNP > 1500 pg/mL at the time of admission.
- ▪
- Fulfill the criterion of a polypathological patient, defined as the presence of 2 or more concomitant chronic diseases.
- ▪
- To have performed dynamometry (Handgrip) as a measure of muscle strength at the time of admission.
- ▪
- To have accepted and signed the informed consent by the patient or a legal representative.
- ▪
- Complete clinical follow-up for one year.
2.3. Variables Studied
2.4. Statistical Study
2.5. Work Methodology
2.6. Ethical Aspects
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Variable | n = 377 |
---|---|
Normal muscle strength | 67 (17.77%) |
Low muscle strength | 310 (82.23%) |
Epidemiological variables | |
Sex (n, %) | |
Men (n, %) | 166 (44.03%) |
Women (n, %) | 211 (55.97%) |
Age (mean, SD) | 83 (±9) |
Anthropometric variables | |
Weight (kg) (mean, SD) | 73 (±17) |
Height (cm) (mean, SD) | 160 (±9) |
BMI (kg/m2) (median, RIC) | 27 (24, 32) |
Comorbidities | |
Arterial hypertension (n, %) | 343 (90.98%) |
Diabetes mellitus (n, %) | 177 (46.95%) |
Dyslipemia (n, %) | 245 (64.99%) |
Atrial fibrillation (n, %) | 286 (75.86%) |
Chronic renal disease (n, %) | 204 (54.11%) |
Chronic respiratory disease (n, %) | 156 (41.38%) |
Cerebro-Vascular disease (n, %) | 69 (18.65%) |
Cognitive impairment (n, %) | 37 (9.81%) |
Neoplasia (n, %) | 33 (8.75%) |
Osteoarticular disease (n, %) | 94 (24.93%) |
Clinical Variables | |
Heart failure etiology (n, %) | |
Hypertensive (n, %) | 154 (40.85%) |
Ischemic (n, %) | 75 (19.89%) |
Dilated (n, %) | 8 (2.12%) |
Valvular (n, %) | 86 (22.81%) |
Amyloidosis (n, %) | 14 (3.71%) |
Others (n, %) | 40 (10.61%) |
Previous year hospital admission (n, %) | |
0 (n, %) | 56 (14.85%) |
1 (n, %) | 166 (44.03%) |
2 (n, %) | 87 (23.08%) |
3 (n, %) | 41 (10.88%) |
4 (n, %) | 16 (4.24%) |
5 (n, %) | 5 (1.33%) |
6 (n, %) | 5 (1.33%) |
8 (n, %) | 1 (0.27%) |
Everest scale (mean, SD) | 7 (±3) |
NYHA functional class (n, %) | |
I (n, %) | 14 (3.71%) |
II (n, %) | 169 (44.83%) |
III (n, %) | 179 (47.48%) |
IV (n, %) | 15 (3.98%) |
LVEF (%) (mean, SD) | 52 (±13) |
Analytical Variables | |
Hemoglobin (g/dL) (median, IQR) | 12 (10, 13) |
Lymphocytes (×106/L) (median, IQR) | 800 (10, 1429) |
Creatinine (mg/dL) (median, IQR) | 1 (1, 2) |
LDL (g/dL) (median, IQR) | 73 (54, 93) |
Albumin (g/dL) (median, IQR) | 4 (3, 4) |
NTproBNP (pg/mL) (median, IQR) | 5500 (2956, 10,493) |
CA-125 (U/mL) (median, IQR) | 41 (20, 89) |
Functionality, nutrition and frailty variables | |
SPPB (median, IQR) | 3 (0, 6) |
Barthel (median, IQR) | 75 (50, 95) |
MNA-SF (median, IQR) | 11 (9, 13) |
PROFUND index (median, IQR) | 6 (3, 10) |
Rockwood | |
Robust | 5 (1.33%) |
Well, without disease | 8 (2.12%) |
Well, disease controlled | 75 (19.89%) |
Vulnerable | 78 (20.69%) |
Light IADL dependence | 77 (20.42%) |
Help for IADL and BADL | 119 (31.56%) |
Dependent | 13 (3.45%) |
Unknown | 2 (0.53%) |
Treatment | |
Furosemide maximal dose (mg/day) (median, IQR) | 80 (60,120) |
Corticoids (n, %) | 99 (26.26%) |
Protein supplements (n, %) | 37 (9.81%) |
Morphine (n, %) | 50 (13.26%) |
Prognostic Variables | |
Death during admission (n, %) | 22 (5.84%) |
Death at 12 months (n, %) | 36 (9.55%) |
12 months readmission (n, %) | 132 (35.01%) |
Variable | Low Muscle Strength (n = 310) | Normal Muscle Strength (n = 67) | p |
---|---|---|---|
Epidemiological Variables | |||
Sex (n, %) | p = 0.6 | ||
Men (n, %) | 133 (42.90%) | 33 (49.25%) | |
Women (n, %) | 177 (57.10%) | 34 (50.75%) | |
Age (mean, SD) | 84 (±8) | 78 (±10) | p < 0.001 |
Anthropometric variables | |||
Weight (kg) (mean, SD) | 72 (±17) | 78 (±16) | p = 0.016 |
Height (cm) (mean, SD) | 160 (±9) | 164 (±9) | p = 0.003 |
BMI (kg/m2) (median, IQR) | 27 (24, 32) | 29 (25, 32) | p = 0.4 |
Comorbidities | |||
Arterial hypertension (n, %) | 285 (91.94%) | 58 (86.57%) | p = 0.4 |
Diabetes mellitus (n, %) | 147 (47.42%) | 30 (44.78%) | p = 0.8 |
Dyslipemia (n, %) | 200 (64.52%) | 45 (67.16%) | p = 0.8 |
Atrial fibrillation (n, %) | 237 (76.45%) | 49 (73.13%) | p = 0.8 |
Chronic renal disease (n, %) | 168 (54.19%) | 36 (53.73%) | p > 0.9 |
Chronic respiratory disease (n, %) | 128 (41.29%) | 28 (41.79%) | p > 0.9 |
Cerebro-Vascular disease (n, %) | 60 (19.35%) | 9 (13.43%) | p = 0.5 |
Cognitive impairment (n, %) | 37 (11.94%) | 0 (0%) | p = 0.021 |
Neoplasia (n, %) | 29 (9.35%) | 4 (5.97%) | p = 0.6 |
Osteoarticular disease (n, %) | 80 (25.80%) | 14 (20.90%) | p = 0.6 |
Clinical Variables | |||
Heart failure etiology (n, %) | p = 0.15 | ||
Hypertensive (n, %) | 132 (42.58%) | 22 (32.84%) | |
Ischemic (n, %) | 55 (17.74%) | 20 (29.85%) | |
Dilated (n, %) | 5 (1.61%) | 3 (4.48%) | |
Valvular (n, %) | 74 (23.87%) | 12 (17.91%) | |
Amyloidosis (n, %) | 13 (4.19%) | 1 (1.49%) | |
Others (n, %) | 31 (10.00%) | 9 (13.43%) | |
Previous year hospital admissions (n, %) | p = 0.047 | ||
0 (n, %) | 42 (13.55%) | 14 (20.90%) | |
1 (n, %) | 133 (42.90%) | 33 (49.25%) | |
2 (n, %) | 75 (24.19%) | 12 (17.91%) | |
3 (n, %) | 34 (10.97%) | 7 (10.45%) | |
4 (n, %) | 15 (4.84%) | 1 (1.49%) | |
5 (n, %) | 5 (1.61%) | 0 (0%) | |
6 (n, %) | 5 (1.61%) | 0 (0%) | |
8 (n, %) | 1 (0.32%) | 0 (0%) | |
Everest Scale (mean, SD) | 7 (±3) | 7 (±3) | p = 0.4 |
NYHA functional class (n, %) | p = 0.016 | ||
I (n, %) | 9 (2.90%) | 5 (7.46%) | |
II (n, %) | 129 (41.61%) | 40 (59.70%) | |
III (n, %) | 159 (51.29%) | 20 (29.85%) | |
IV (n, %) | 13 (4.19%) | 2 (2.99%) | |
LVEF (%) (mean, SD) | 52 (±12) | 48 (±14) | p = 0.033 |
Analytical Variables | |||
Hemoglobin (g/dL) (median, IQR) | 12 (10, 13) | 12 (11, 13) | p = 0.4 |
Lymphocytes (×106/L) (median, IQR) | 800 (11, 1498) | 700 (7, 1355) | p = 0.2 |
Creatinine (mg/dL) (median, IQR) | 1 (1, 2) | 1 (1, 2) | p = 0.6 |
LDL (g/dL) (median, IQR) | 74 (55, 92) | 70 (53, 93) | p = 0.7 |
Albumin (g/dL) (median, IQR) | 4 (3, 4) | 4 (3, 4) | p = 0.057 |
NTproBNP (pg/mL) (median, IQR) | 5512 (2733, 10,153) | 5417 (3278, 10,726) | p = 0.7 |
CA-125 (U/mL) (median, IQR) | 39 (19, 89) | 49 (27, 90) | p = 0.4 |
Functionality, nutrition and frailty variables | |||
SPPB (median, IQR) | 2 (0, 5) | 5 (2, 9) | p < 0.001 |
Barthel (median, IQR) | 70 (45, 95) | 95 (80, 100) | p < 0.001 |
MNA-SF (median, IQR) | 10 (9, 12) | 11 (10, 14) | p = 0.056 |
PROFUND index (median, IQR) | 7 (3, 11) | 3 (2, 5) | p < 0.001 |
Rockwood | p < 0.001 | ||
Robust | 2 (0.65%) | 3 (4.48%) | |
Well, without disease | 5 (1.61%) | 3 (4.48%) | |
Well, disease controlled | 53 (17.10%) | 22 (32.84%) | |
Vulnerable | 63 (20.32%) | 15 (22.39%) | |
Light IADL dependence | 63 (20.32%) | 14 (20.90%) | |
Help for IADL and BADL | 111 (35.80%) | 8 (11.94%) | |
Dependent | 13 (4.19%) | 0 (0%) | |
Unknown | 0 (0%) | 2 (2.99%) | |
Treatment | |||
Furosemide maximal dose (mg/day) (median, IQR) | 80 (60,120) | 120 (60, 160) | p = 0.047 |
Corticoids (n, %) | 90 (29.03%) | 9 (13.43%) | p = 0.033 |
Protein supplements (n, %) | 33 (10.65%) | 4 (5.97%) | p = 0.5 |
Morphine (n, %) | 41 (13.23%) | 9 (13.43%) | p > 0.9 |
Prognostic variables | |||
Death during admission (n, %) | 19 (6.13%) | 3 (4.48%) | p = 0.8 |
Death at 12 months (n, %) | 32 (10.32%) | 4 (5.97%) | p = 0.23 |
12 months readmission (n, %) | 111 (35.81%) | 21 (31.34%) | p = 0.27 |
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Guzmán-Carreras, A.; San Miguel-Agudo, J.; Paz-Cabezas, M.; Bernabeu-Wittel, M.; Muñoz-Rivas, N.; Sánchez-Sauce, B.; Aguilar-Rodríguez, F.; Cabeza-Osorio, L.; Andrès, E.; Lorenzo-Villalba, N.; et al. Low Muscle Strength Assessed with Dynamometry in Elderly Polypathological Patients with Acute Heart Failure: PROFUND-IC Registry. J. Clin. Med. 2024, 13, 4873. https://doi.org/10.3390/jcm13164873
Guzmán-Carreras A, San Miguel-Agudo J, Paz-Cabezas M, Bernabeu-Wittel M, Muñoz-Rivas N, Sánchez-Sauce B, Aguilar-Rodríguez F, Cabeza-Osorio L, Andrès E, Lorenzo-Villalba N, et al. Low Muscle Strength Assessed with Dynamometry in Elderly Polypathological Patients with Acute Heart Failure: PROFUND-IC Registry. Journal of Clinical Medicine. 2024; 13(16):4873. https://doi.org/10.3390/jcm13164873
Chicago/Turabian StyleGuzmán-Carreras, Alicia, Jorge San Miguel-Agudo, Mateo Paz-Cabezas, Máximo Bernabeu-Wittel, Nuria Muñoz-Rivas, Beatriz Sánchez-Sauce, Fernando Aguilar-Rodríguez, Luis Cabeza-Osorio, Emmanuel Andrès, Noel Lorenzo-Villalba, and et al. 2024. "Low Muscle Strength Assessed with Dynamometry in Elderly Polypathological Patients with Acute Heart Failure: PROFUND-IC Registry" Journal of Clinical Medicine 13, no. 16: 4873. https://doi.org/10.3390/jcm13164873