Application and evidence gaps of sarcopenia diagnostic criteria in patients with heart failure: a scoping review.

Authors

Mingzhe Li, Wei Lv, Ting Li, Lijun Su, Qing Zhao, Hui Xu, Jianxiu Man

Published in

Frontiers in medicine. Volume 13. Pages 1957639. Epub Sep 29, 2026.

Abstract

Diagnostic criteria for sarcopenia show heterogeneity in patients with heart failure (HF). This study reviews existing evidence through a scoping review.
We searched six databases (PubMed, Embase, CINAHL, Web of Science, China National Knowledge Infrastructure [CNKI], and Wanfang) from inception to May 2026. Two reviewers screened literature and extracted data independently. We used narrative synthesis.
We included 23 studies covering 8 diagnostic criteria. The Asian Working Group for Sarcopenia (AWGS) 2019 (9 studies) and the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) (7 studies) were most common. The overall prevalence ranged from 8.9% to 65.8%, with wide variation within the same criterion. Only 3 studies performed head-to-head comparisons. Heart failure-specific factors (edema interference, New York Heart Association [NYHA] class limitation, timing of assessment in acute phase) received limited attention. No study assessed sarcopenia at acute decompensation before diuresis. One study evaluated patients with stage B HF, generally considered pre-HF, and was interpreted separately. Eleven studies reported prognostic associations, yet only 1 reported discrimination and reclassification metrics such as concordance index (C-index), net reclassification improvement (NRI), and integrated discrimination improvement (IDI). External validation of diagnostic and prognostic performance was insufficient.
Current evidence does not support a unified heart failure-specific diagnostic framework for sarcopenia. Future work should include multicenter prospective cohort studies to establish HF-specific cut-off values, develop assessment protocols for acute decompensated HF and NYHA class IV patients, and conduct large-sample external validation of diagnostic and prognostic performance.

PMID:
42871368
Bibliographic data and abstract were imported from PubMed on 14 Oct 2026.

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