Sarcopenia and Arrhythmia Risk: An Electrocardiographic Analysis in Older Adults

Abstract

Objective: Sarcopenia and cardiac arrhythmias are common in older adults and may have similar processes such as inflammation, fibrosis, mitochondrial dysfunction, and oxidative stress. These processes can cause myocardial remodeling and electrical instability. This study was designed to examine the link between sarcopenia and electrocardiographic (ECG) markers of arrhythmia. Materials and Methods: In this cross-sectional, retrospective study, 283 older adults living in the community aged 60 years or older who underwent comprehensive geriatric assessment were included. Sarcopenia was defined per the European Working Group on Sarcopenia in Older People 2 criteria, using handgrip strength with population-specific thresholds (men <35 kg, women <20 kg), and skeletal muscle mass index (SMMI) [SMMI = SMM/body mass index (BMI). Standard 12-lead ECGs were analyzed for arrhythmic patterns and conduction abnormalities, including P-wave dispersion (PWD), corrected QT interval (QTc), Tp-e/QTc ratio, Tp-e interval, fragmented QRS, frontal QRST angle, first-degree atrioventricular block, bundle branch block, premature ventricular and atrial contractions, and atrial fibrillation (AF). Multivariate logistic regression identified independent associations. Results: Sarcopenia was present in 35.7% of participants and was associated with older age, female sex, obesity, frailty, and functional impairment. ECG abnormalities were more frequent in individuals with sarcopenia, including AF (p=0.038), fragmented QRS (p=0.032), and increased PWD (p=0.010). In multivariate analysis, fragmented QRS [odds ratio (OR): 2.464, 95% confidence interval (CI): 1.068-5.683, p=0.035], obesity (OR: 2.030), frailty (OR: 1.970), and age (OR: 1.104) were independently associated with sarcopenia. When PWD replaced fragmented QRS, it also showed a significant association (OR: 1.018; 95% CI: 1.001-1.037; p=0.042). Conclusion: Sarcopenia is independently associated with ECG abnormalities suggestive of atrial and ventricular electrical remodeling, especially fragmented QRS and PWD.