慢性心力衰竭合并肌少症的研究进展

Research progress of sarcopenia combined with chronic heart failure

慢性心力衰竭(CHF)是一种常见的心脏疾病,而肌少症则是世界卫生组织2016年新认定的一种疾病,以进行性骨骼肌量、肌力和(或)躯体功能下降为特征,两者均在老年人群高发。本文全面综述了CHF合并肌少症的流行病学特点、发病机制、干预措施和预后。现有研究证据表明,肌少症在CHF患者中具有较高患病率,CHF患者发生肌少症的机制尚未阐明,可能与CHF导致的厌食症、营养不良、活动量减少、慢性炎症和激素水平变化等相关。对于CHF合并肌少症患者而言,适当的体力活动和营养补剂可能有益。对于血清维生素D水平降低的CHF患者,补充维生素D可能有益。鉴于肌少症可导致CHF患者生存时间缩短、再入住院率增加和生活质量下降,有必要提高CHF患者和临床工作者对肌少症的认识,及早对CHF患者进行肌少症的筛查、预防和干预。

Chronic heart failure(CHF)is a common heart disease,and sarcopenia is a recently recognized disease by the World Health Organization in 2016,characterized by a progressive decrease in skeletal muscle mass,muscle strength,and/or physical performance.Both are highly prevalent in the elderly.This article provides a comprehensive review of the epidemiological features,pathogenesis,interventions,and prognosis of patients with both sarcopenia and CHF.Current evidence suggests that sarcopenia has a high prevalence in CHF patients,but the mechanisms has not been elucidated.However,anorexia,malnutrition,reduced physical activities,chronic inflammation,and changes in hormone levels due to CHF might contribute to the occurrence of sarcopenia.Appropriate amount of exercise and nutritional supplements may be beneficial in patients with comorbid CHF and sarcopenia,and vitamin D supplementation may be beneficial for those with low serum vitamin D.In light of the fact that sarcopenia can shorten survival,increase readmission rates,and decrease quality of life of CHF patients,it is necessary to improve the awareness of CHF patients and clinicians about sarcopenia,and screening,prevention,and intervention should be implemented as early as possible for sarcopenia in CHF patients.