Calf size and physical function predict heart failure mortality

In a multicenter study of 7,362 Japanese patients aged 65 and older hospitalized with heart failure, researchers evaluated how muscle mass and physical performance interact to predict one-year mortality. Calf circumference measures nutritional status and muscle mass, but peripheral edema can confound these readings in heart failure. To improve risk stratification, investigators combined calf circumference with the Short Physical Performance Battery.

The team divided participants from the J-Proof HF Registry into a training cohort of 4,417 patients and a temporal validation cohort of 2,945 patients. Decision-tree analysis established cutoff values that separated patients into three risk groups, defining low risk as a physical performance score of 10 or higher and a calf circumference of at least 25.9 centimeters. Model performance was confirmed using Kaplan-Meier and multivariable Cox regression analyses.