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Consolidating Concepts From Recent International Expert Consensus on Sarcopenia: Implications for Heart Failure
Gloria H W Lau1, Tung Wai Auyeung2, Emer Joyce3
1Gerald Choa Cardiac Research Centre and Laboratory for Heart Failure + Circulation Research, Li Ka Shing Institute of Health Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; Centre for Cardiovascular Genomics & Medicine and HK HOPE, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
Journal of Cardiac Failure
|June 18, 2025
Summary
Heart failure (HF) management needs to integrate sarcopenia screening and diagnosis. This review addresses gaps in current guidelines and proposes a pathway for early detection and management of sarcopenia in HF patients.
Area of Science:
- Cardiology
- Geriatrics
- Muscle Physiology
Background:
- Sarcopenia, muscle loss, significantly impacts heart failure (HF) patient quality of life and recovery.
- Existing sarcopenia guidelines primarily focus on aging, neglecting HF-specific considerations.
- Current HF guidelines lack comprehensive strategies for sarcopenia assessment and management.
Purpose of the Study:
- To review international sarcopenia consensus documents (2019-2024) relevant to heart failure.
- To identify knowledge gaps and recent advancements in HF treatment and interventions impacting sarcopenia.
- To propose an integrated, multidisciplinary care pathway for sarcopenia in HF management.
Main Methods:
- Systematic review of major international sarcopenia consensus documents published between 2019 and 2024.
- Analysis of recent developments in HF pharmacotherapy (e.g., SGLT2 inhibitors) and non-pharmacological interventions (e.g., rehabilitation, inspiratory muscle training).
- Reformulation of a 4-step sarcopenia management pathway (Find-Assess-Confirm-Severity) for HF patients.
Main Results:
- Significant focus on aging-related sarcopenia, with limited attention to HF.
- Identified knowledge gaps including sarcopenic obesity and cardiac atrophy in HF.
- Highlighted potential benefits of SGLT2 inhibitors, rehabilitation, and inspiratory muscle training for sarcopenic HF patients.
Conclusions:
- Heart failure management requires explicit inclusion of sarcopenia screening and diagnosis.
- A multidisciplinary approach is crucial for implementing a structured sarcopenia management pathway in HF.
- Early identification and management of sarcopenia can improve outcomes for heart failure patients.
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