Background: Chronic heart failure (CHF) is a complex clinical syndrome associated with muscle wasting, which can progress to cardiac cachexia. Myostatin, a negative regulator of muscle growth, has been implicated in the pathophysiology of muscle wasting in CHF patients and suggested as a potential biomarker. The objective of this study was to investigate serum myostatin concentration in patients with CHF with preserved and reduced ejection fraction. Methods: The authors conducted a single-centre study comparing serum myostatin levels, functional and echocardiographic parameters, muscle mass, strength and function in patients with CHF to a control group without CHF. The study group was further divided into sub-groups with preserved and reduced or mildly reduced ejection fraction. Results: Results showed no significant differences in myostatin concentration between CHF patients and controls, and no correlation with sarcopenia or dynapenia. However, a higher myostatin concentration was found in patients with impaired systolic function (Me = 1675 pg/mL vs. Me-884.5 pg/mL; p = 0.007). A positive correlation between myostatin concentration and muscle mass (r = 0.27; p = 0.04), and functional parameters such as Norton (r = 0.35; p < 0.01), I-ADL (r = 0.28; p = 0.02) and Barthel scale (r = 0.27; p = 0.03) scores, was also observed. Conclusions: Myostatin appears to play a role in muscle wasting and its progression to cardiac cachexia in patients with impaired ejection fraction. Further research is needed to confirm these findings and explore myostatin's potential as a biomarker for muscle loss and a target for pharmacotherapeutic agents in this population of patients.
Keywords: biomarker; cardiac cachexia; elderly; geriatrics; heart failure; left ventricular ejection fraction; muscle wasting; myostatin; sarcopenia.