Sarcopenia and Cardiovascular Diseases.
Sarcopenia and Cardiovascular Diseases.
复制标题
肌肉减少症和心血管疾病。
DOI：
10.1161/circulationaha.123.064071
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发表时间：
2023-05-16
期刊：
影响因子：
37.8
通讯作者：
Goyal, Parag
中科院分区：
文献类型：
--
作者：
Damluji, Abdulla A.;Alfaraidhy, Maha;AlHajri, Noora;Rohant, Namit N.;Kumar, Manish;Al Malouf, Christina;Bahrainy, Samira;Kwak, Min Ji;Batchelor, Wayne B.;Forman, Daniel E.;Rich, Michael W.;Kirkpatrick, James;Krishnaswami, Ashok;Alexander, Karen P.;Gerstenblith, Gary;Cawthon, Peggy;deFilippi, Christopher R.;Goyal, Parag
肌肉减少症是肌肉力量、质量和功能的丧失，通常因慢性合并症加重，包括心血管疾病、慢性肾病和癌症。骨骼肌减少症与心血管疾病的更快进展、更高的死亡、跌倒风险和生活质量下降有关，特别是在老年人中。尽管病理生理机制是复杂的，但肌肉减少症的广泛潜在原因包括合成代谢和分解代谢肌肉平衡之间的不平衡，伴或不伴神经元变性。衰老、慢性疾病、营养不良和不活动等内在的分子机制与肌肉减少症的发生有关。对于那些患有慢性疾病的人来说，肌肉减少症的筛查和检测尤其重要。早期识别肌肉减少症很重要，因为它可以为干预提供机会，以逆转或延缓肌肉疾病的进展，这可能最终影响心血管疾病的结局。依靠身体质量指数对筛查没有帮助，因为许多患者患有肌肉减少性肥胖，这是老年心脏病患者中特别重要的表型。在这篇综述中，我们的目的是：(1)在肌肉萎缩疾病的背景下提供肌肉减少症的定义；(2)总结肌肉减少症与不同心血管疾病的关系；(3)强调诊断评估的方法；(4)探讨肌肉减少症的治疗策略；(5)概述对该领域未来的影响的关键知识差距。
Sarcopenia is the loss of muscle strength, mass, and function, which is often exacerbated by chronic comorbidities including cardiovascular diseases, chronic kidney disease, and cancer. Sarcopenia is associated with faster progression of cardiovascular diseases and higher risk of mortality, falls, and reduced quality of life, particularly among older adults. Although the pathophysiologic mechanisms are complex, the broad underlying cause of sarcopenia includes an imbalance between anabolic and catabolic muscle homeostasis with or without neuronal degeneration. The intrinsic molecular mechanisms of aging, chronic illness, malnutrition, and immobility are associated with the development of sarcopenia. Screening and testing for sarcopenia may be particularly important among those with chronic disease states. Early recognition of sarcopenia is important because it can provide an opportunity for interventions to reverse or delay the progression of muscle disorder, which may ultimately impact cardiovascular outcomes. Relying on body mass index is not useful for screening because many patients will have sarcopenic obesity, a particularly important phenotype among older cardiac patients. In this review, we aimed to: (1) provide a definition of sarcopenia within the context of muscle wasting disorders; (2) summarize the associations between sarcopenia and different cardiovascular diseases; (3) highlight an approach for a diagnostic evaluation; (4) discuss management strategies for sarcopenia; and (5) outline key gaps in knowledge with implications for the future of the field.