Complex Issues of Cardiovascular Diseases · Oct 31, 2026

RESPIRATORY SARCOPENIA IN ELDERLY PATIENTS WITH STABLE ISCHEMIC HEART DISEASE

By Bogulko K, Dorogova EA, Bazdyrev ED et al.

Highlights Impairments in muscle status (sarcopenia and/or respiratory muscle weakness) were identified in 26,3% of elderly patients with stable ischemic heart disease. Among all patients with muscle status abnormalities, generalized sarcopenia was the most common (37.2%). Respiratory sarcopenia–defined as a combination of generalized sarcopenia and respiratory muscle weakness–occurred half as frequently, in 18.1% of cases. Notably, nearly half of the patients (44.7%) exhibited isolated respiratory muscle weakness without confirmed generalized sarcopenia. Aim. To assess the prevalence of respiratory sarcopenia (RS) in elderly patients with stable ischemic heart disease (IHD). Methods. The study included 358 elderly patients with ischemic heart disease; the median age was 65 (60; 69) years. Respiratory muscle strength was assessed in all participants by measuring maximal expiratory (MEP) and inspiratory (MIP) mouth pressures. Sarcopenia was diagnosed according to the EWGSOP (2019) criteria. Respiratory sarcopenia (RS) was diagnosed in patients presenting with a combination of reduced respiratory muscle strength and sarcopenia. Results. An assessment of muscle status revealed generalized sarcopenia in 35 patients (9.8%) and respiratory sarcopenia (RS) in 17 patients (4.8%); isolated respiratory muscle weakness was found in 42 patients (11.7%), while the majority of patients (264; 73.7%) showed no abnormalities in muscle status. Reduced respiratory muscle strength was detected in 16.5% of patients; among this subgroup, 28.8% presented with RS, and 71.2% with isolated respiratory muscle weakness. These abnormalities most frequently manifested as a combined reduction in MIP and MEP (8.1%), and less frequently as an isolated reduction in MIP (7.3%) or MEP (1.1%). The median MEP value was 1.2 times higher than the median MIP value. Correlation analysis revealed associations between respiratory muscle strength parameters and various clinical and instrumental data (age, body mass index, height, handgrip strength, muscle area, and skeletal muscle index). Conclusion. Impairments in muscle status were identified in more than one out of every four of elderly patients with ischemic heart disease. Generalized sarcopenia was confirmed in 37.2% of these patients, whereas respiratory sarcopenia was found half as frequently (18.1%). Respiratory muscle strength was preserved in the majority of patients (83.5%); however, a decline was observed in one in six (16.5%), most commonly manifesting as combined inspiratory and expiratory muscle dysfunction, with expiratory strength exceeding inspiratory strength by a factor of 1.2. Nearly half of the muscle status abnormalities (44.7%) consisted of isolated respiratory muscle weakness.

doi.org/10.17802/2306-1278-2026-15-5-6-18Open accessPopulations