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Erschienen in: Clinical Research in Cardiology 12/2014

01.12.2014 | Original Paper

Creatinine excretion rate, a marker of muscle mass, is related to clinical outcome in patients with chronic systolic heart failure

verfasst von: Jozine M. ter Maaten, Kevin Damman, Hans L. Hillege, Stephan J. Bakker, Stefan D. Anker, Gerjan Navis, Adriaan A. Voors

Erschienen in: Clinical Research in Cardiology | Ausgabe 12/2014

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Abstract

Aims

In chronic heart failure (CHF), low body mass as a reflection of low muscle mass has been associated with poor outcome. Urinary creatinine excretion rate (CER) is an established marker of muscle mass, but has not been investigated in CHF. This study aims to evaluate urinary CER as a marker of muscle mass in patients with CHF and establish the relationship with clinical outcome.

Methods and results

In 120 patients with CHF, we evaluated CER as determined by mean creatinine excretion rate in two consecutive 24-h urine collections. We evaluated the relationship between CER and clinical variables using linear regression. Finally, we evaluated the association between CER and clinical outcome. Mean age was 59 ± 12 years, and 80 % were male. Mean CER was 1,383 mg/day (range 412–2,930). Independent predictors of CER were body surface area (BSA) (β = 0.404, P < 0.001), gender (β = −0.180, P = 0.029), log N terminal pro-brain natriuretic peptide (NTproBNP) (β = −0.172, P = 0.048) and age (β = −0.168, P = 0.035). During three years of follow-up, 33 patients (28 %) developed a clinical endpoint, defined as the first occurrence of either all-cause death, heart transplantation, myocardial infarction, or hospitalization for heart failure during three years of follow-up. In Cox regression analyses, log CER was associated with the occurrence of the clinical endpoint independent of age, gender, BSA, glomerular filtration rate and urinary albumin excretion, [hazard ratio 7.67 (1.82–32.3) per log decrease], but not independent of NTproBNP [hazard ratio 3.66 (0.79–17.0), P = 0.098].

Conclusions

Low urinary CER is associated with smaller body dimensions and more severe heart failure and is associated with an increased risk of adverse outcome.
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Metadaten
Titel
Creatinine excretion rate, a marker of muscle mass, is related to clinical outcome in patients with chronic systolic heart failure
verfasst von
Jozine M. ter Maaten
Kevin Damman
Hans L. Hillege
Stephan J. Bakker
Stefan D. Anker
Gerjan Navis
Adriaan A. Voors
Publikationsdatum
01.12.2014
Verlag
Springer Berlin Heidelberg
Erschienen in
Clinical Research in Cardiology / Ausgabe 12/2014
Print ISSN: 1861-0684
Elektronische ISSN: 1861-0692
DOI
https://doi.org/10.1007/s00392-014-0738-7

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