Spot Urinary Creatinine Concentration in Patients with Chronic Heart Failure Identifies a Distinct Muscle-Wasting Phenotype with a Strikingly Different Risk of Mortality

Autor: Jolanta Malinowska-Borowska, Marta Buczkowska, Sylwia Duda, Apolonia Stefaniak, Jacek Niedziela, Jolanta Urszula Nowak, Jadwiga Nessler, Karol Adam Kamiński, Mariusz Gąsior, Piotr Rozentryt
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Biomedicines, Vol 11, Iss 9, p 2342 (2023)
Druh dokumentu: article
ISSN: 2227-9059
DOI: 10.3390/biomedicines11092342
Popis: Background. There is a raising awareness that heart failure (HF) is a highly heterogeneous, multiorgan syndrome with an increasing global prevalence and still poor prognosis. The comorbidities of HF are one of the key reasons for presence of various phenotypes with different clinical profile and outcome. Heterogeneity of skeletal muscles (SMs) quantity and function may have an impact on patient’s phenotype. Aim. We intended to compare clinical characteristics of phenotypes defined by a combination of various SM mass taken as a fat-free compartment from DEXA scans and different levels of SUCR (Spot Urinary Creatinine). All-cause mortality with mortality predicted by MAGGIC in such phenotypes were compared. Methods. In 720 HF patients with reduced ejection fraction (age: 52.3 ± 10 years, female: 14%, NYHA: 2.7 ± 0.7, LVEF: 24.3 ± 7.3%), admitted to the hospital for heart transplantation candidacy assessment, morning SUCR along with body composition scanning (DEXA) was performed. All study participants were dichotomized twice, first by low or normal appendicular muscle mass index (ASMI) and second by SUCR (Spot Urinary Creatinine) < and ≥of 1.34 g/L. Four study groups (phenotypes) were created as combinations of lower or higher SUCR and low or normal ASMI. Results. Low ASMI was found in 242 (33.6%) patients, while the remaining 478 had normal muscle mass. In 446 patients (61.9%), SUCR was
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