posted on 2024-12-03, 16:04authored bySafiyyah A Suleman, Joanna Bilak, Amitha Puranik, Gerry P McCann, Iain B Squire
Introduction: Skeletal muscle (SkM) abnormalities are well-recognised in heart failure (HF). We aimed to systematically review studies of SkM energetics in patients with HF at rest and post-exercise using 31phosphorus magnetic resonance spectroscopy (31P MRS). Methods: A systematic search of cross-sectional studies used predefined search terms related to HF, SkM energetics, and 31P MRS (PROSPERO ID: CRD42023434698). Inclusion criteria for studies are as follows: 1. HF participants versus controls; and 2. SkM energetics assessed using 31P MRS reporting BOTH (i) PCr recovery time and (ii) PCr ratios (PCr/Pi and/or PCr/ATP). The primary outcome was SkM PCr recovery time following exercise, comparing patients with diagnosed HF and healthy controls and reported as standardised mean difference (SMD). Results: Of 465 identified studies, 6 met the inclusion criteria and were conducted from 1987 to 2021, comprising 162 participants (N = 86 HF, N = 76 healthy controls). HF patients (mean age 55.1 ± 4.16 years, 49 (56.9%) male) were reasonably matched to healthy controls (mean age 50 ± 8.9 years, 54 (71%) males). Two studies did not report patients’ ejection fractions (EF); the mean EF among patients from the remaining six studies was 24.8%. No studies specifically included participants with HFpEF and none characterised sarcopenia. HF patients exhibited impaired SkM energetics compared to healthy controls, which were characterised by a significantly increased PCr recovery time (SMD: −1.35, CI: −2.11, −0.59). Conclusions: PCr recovery is significantly impaired in patients with HFrEF. Females were under-represented, no HFpEF studies were identified, and no studies linking abnormal SkM energetics directly to sarcopenia were identified.
Funding
This work was supported by Leicester NIHR Biomedical Research Centre, the British Heart Foundation and the University of Leicester, which provides funding matched to the BHF award to S.A.S. J.B. is supported by the British Society for Heart Failure Research Fellowship Award BSH/JB/001. G.P.M. received funding from the National Institute for Health and Care Research (NIHR) United Kingdom through a Research Professorship award (RP-2017-08-ST2-007).