Impact of heart failure on skeletal muscle: an overview

Heart failure (HF) is a complex clinical syndrome that promotes high morbidity and multi-systemic damage. Skeletal muscle can be directly affected by HF through a loss of physical capacity and various inflammatory, hormonal, and metabolic mechanisms observed in this cardiac condition, which collectively contribute to a high prevalence of sarcopenia in HF patients. Therefore, the aim of this review was to compile the main recent clinical and epidemiological data on muscle health in HF patients. Nine studies were selected from systematic reviews and clinical trials, which demonstrated a high prevalence of sarcopenia in patients with HF, particularly in males, hospitalized patients, the elderly, and those with HF with reduced ejection fraction. Oxidative stress markers and higher levels of natriuretic peptides were also observed in HF patients who exhibited damaged muscle parameters. Furthermore, the overall deterioration of prognosis in HF was associated with criteria defining sarcopenia, such as low muscle strength and lean mass loss. These findings reinforce the importance of evaluating skeletal muscle in HF patients, which can provide improvements in morbidity and functionality.