所属 医学部 医学科（東京女子医科大学病院） 職種 准教授
|発表タイトル||Skeletal Muscle Mass Determined by Bioelectrical Impedance Analysis is Associated With Exercise Capacity and Cardiac Events in Patients With Congenital Heart Disease|
|会議名||American Heart Association Scientific Sessions 2017|
|発表者・共同発表者||◎SATO Masaki, TOMIMATSU HIROFUMI, Inai Kei, SHIMIZU MIKIKO, SHINOHARA Tokuko, Takeuchi Daiji, TOYOHARA KEIKO, HISASHI SUGIYAMA|
Exercise capacity of patients with heart failure (HF) was thought to entirely associate with oxygen supply as central hemodynamic factor. However, skeletal muscle disorders in patients with HF have been recently reported to contribute to exercise intolerance. Bioelectrical impedance analysis (BIA) is a rapid and non-invasive method that measures skeletal muscle mass (SMM) and has been widely used in clinical research. However, little has been reported regarding SMM values in patients with congenital heart disease (CHD).
We assessed the hypothesis that SMM determined by BIA is associated with exercise capacity and prevalence of cardiac events in patients with CHD.
We performed a prospective single-center study of 222 consecutive patients (mean age, 33 [range 12–76] years; 48% males) with CHD, who were admitted to our institute between April 2013 and April 2016. We determined SMM of patients by BIA, and reviewed their medical records in order to evaluate the relationship between SMM and either exercise capacity or prevalence of cardiac events.
A significant correlation was found between 6-minute walking test distance and whole body SMM (r = 0.36, p = 0.002), arms (r = 0.35), trunk (r = 0.34), and legs (r = 0.39), as well as between peak oxygen uptake (peak VO2) and whole body SMM (r = 0.59, p < 0.001), arms (r = 0.54), trunk (r = 0.56), and legs (r = 0.54). During the median 36-month follow-up period, receiving operating characteristic (ROC) curve analysis showed that the cutoff point of SMM for predicting cardiac events was 24.4 for males (area under the curve [AUC], 0.75; sensitivity, 0.92; specificity, 0.54) and 19.1 for females (AUC, 0.73; sensitivity, 0.91; specificity, 0.63). Using the Cox hazard model, we determined that the hazard ratio of cardiac events in male patients with SMM < 24.4 compared to those with SMM ≥ 24.4 was 5.9 (95% confidence interval [CI] 1.6–38.4). The same analysis gave a hazard ratio of 3.2 in female patients with SMM < 19.1 compared to those with SMM ≥ 19.1 (95% CI 1.1–13.8).
SMM determined by BIA correlates with exercise capacity and constitutes a useful tool for predicting cardiac events in patients with CHD.