title: The challenge of frailty and sarcopenia in heart failure with preserved ejection fraction.
abstract: Frailty is a clinical state in which there is an increase in an individual's vulnerability for developing increased dependency and/or mortality when exposed to stressors. Frailty is often accompanied by heart failure with preserved ejection fraction (HFpEF), and frailty is likely to affect its clinical features and outcomes. Frail patients with HFpEF are frequently associated with sarcopenia (ie, muscle loss and weakness), which is a major component of the pathophysiology of frailty. Sarcopenia is a systemic skeletal muscle disease that impairs the function of limb skeletal muscles, as well as respiratory muscles, and this results in further functional decline. In addition, sarcopenia may contribute to cardiovascular remodelling and dysfunction, leading to the development of HFpEF through several metabolic and endocrine abnormalities. Although there is no established strategy for frail patients with HFpEF, a multidisciplinary approach, including various types of muscular training and nutritional intervention, may provide beneficial effects for these patients.
authors.affiliation: Division of Cardiovascular Medicine, Department of Molecular Medicine and Therapeutics, Faculty of Medicine, Tottori University, Yonago, Japan.
authors.forename: Yoshiharu
authors.initials: Y
authors.lastname: Kinugasa
authors.affiliation: Division of Cardiovascular Medicine, Department of Molecular Medicine and Therapeutics, Faculty of Medicine, Tottori University, Yonago, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Yamamoto
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D003661:Decision Support Techniques; D005260:Female; D016330:Frail Elderly; D015577:Geriatric Assessment; D006333:Heart Failure / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D018482:Muscle, Skeletal / Q000503:physiopathology*; D015596:Nutrition Assessment; D009752:Nutritional Status; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors; D055948:Sarcopenia / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D013318:Stroke Volume; D016277:Ventricular Function, Left