Respiratory sarcopenia in patients with pulmonary hypertension

Hiroyasu Murata, Shinya Matsushima, Momoko Masuda, Natsuki Kawamura, Kazuki Tobita, Daiki Shimizu, Takumi Inami, Kyoko Soejima, Takashi Kohno, Ayumi Goda, Hayato Sakamoto
Purpose:

The aim of this study was to investigate the prevalence and determinants of RS in patients with PH.

Methods:

A total of 119 PH patients (85 female, age 64 (50-75) years, body mass index (BMI) 22.7 (20.1-25.5) kg/m², clinical PH classification group 1/group 4/other = 64/42/13, mean pulmonary artery pressure 26 (19-36) mmHg, 6-minute walk distance (6MWD) 414 (332-517) m) who admitted for elective right heart catheterization between June 2023 and March 2024 at the Kyorin University Hospital were included. Six-minute walk test (6MWD), grip strength (Grip), body composition measurements (skeletal muscle mass index (SMI), phase angle (PhA)) and respiratory function/respiratory muscle strength measurement (maximal inspiratory pressure (MIP), forced vital capacity (FVC)) were evaluated. RS was defined as respiratory muscle weakness (MIP: less than predicted value) and low skeletal muscle mass (SMI: 7.0 kg/m² in males and 5.7 kg/m² in females). The univariate logistic regression analysis was performed to determine the association between RS and clinical parameters. Multivariate (adjusted by age, sex) logistic regression analyses were performed to determine the association between RS and parameters that were significant in univariate analysis.

Results:

MIP and SMI were 50.8 (36.6-65.6) cmH2O and 6.1 (5.4-7.1) kg/m², respectively. RS was observed in 35 patients (29%). In multivariate logistic regression analyses, BMI (odds ratio (OR) 0.18, 95% CI 0.08-0.39, p0.01), Grip (OR 0.23, 95% CI 0.10-0.53, p0.01), 6MWD (OR 0.62, 95% CI 0.39-0.98, p=0.04), PhA (OR 0.34, 95% CI 0.18-0.65, p0.01), FVC (OR 0.32, 95% CI 0.15-0.69, p0.01) showed significant negative associations with RS.

Conclusion(s):

The prevalence of RS in PH patients was higher than in the general population. The following factors were identified as determinants of RS in patients with PH: BMI, Grip, exercise capacity, nutritional status, and respiratory function.

Implications:

It is important to increase clinical interest in RS, and to evaluate it from multiple perspectives in patients with PH. Further research is required to validate the efficacy of rehabilitation nutrition for preventing and treating RS.

Funding acknowledgements:
The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.
Keywords:
pulmonary hypertension
sarcopenia
rehabilitation
Primary topic:
Musculoskeletal
Second topic:
Cardiorespiratory
Third topic:
Disability and rehabilitation
Did this work require ethics approval?:
Yes
Name the institution and ethics committee that approved your work:
The Committee for Clinical Studies and Ethics of Kyorin University School of Medicine
Provide the ethics approval number:
1595
Has any of this material been/due to be published or presented at another national or international conference prior to the World Physiotherapy Congress 2025?:
No

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