The NHCS study aimed to study the characteristics of how the heart ages in the local population. PHOTO: ST FILESINGAPORE - Researchers here have found a potential predictor of heart disease among the elderly, after discovering a link between the weakening of skeletal muscle function and heart size.
The skeletal muscle is attached to bones in the body and helps with muscle movement.
The age-related loss of skeletal muscle mass and function is known as sarcopenia, and it affects 10 per cent of older healthy adults.
While such skeletal muscle degeneration is known, the impact of sarcopenia on the ageing heart had not been identified.
This was what the study led by the National Heart Centre Singapore (NHCS) sought to address.
The longitudinal study, known as the Cardiac Ageing Study, began in 2014 and involved more than 300 healthy adults between 40 and 80 years old. It aimed to study the characteristics of how the heart ages - in both structure and function - in the local population.
Based on detailed scans and various assessments such as skeletal muscle mass measurements and hand grip strength tests, the researchers found significant associations between skeletal muscle mass, function and heart structure.
Over 20 per cent of older adults with sarcopenia had a distinct pattern of structurally smaller hearts.
This was even after the findings were adjusted for body size, and the fact that Asians tend to have a smaller build compared with, say, Caucasians, said Assistant Professor Angela Koh, a senior consultant at the Department of Cardiology at NHCS and the principal investigator of the study.
She added that the team also looked for other chronic illnesses such as hypertension and diabetes which could cause a person to lose muscle mass and affect the study's results.
"But in spite of that, we still see this association. This tells us that it is not just the traditional risk factors... and while managing diabetes continuously is very important, we need to look at other things that may actually influence heart health," she said.
Discovering this pattern within the heart muscle suggests an early development, or progression, of cardiovascular disease that occurs jointly in the heart and skeletal muscle, said Prof Koh.
"This provides a window of opportunity to detect this syndrome early on, before heart disease occurs among our aged population," she added.
Assistant Professor Angela Koh said the finding provides the opportunity to detect the syndrome early on. ST PHOTO: NG SOR LUAN
However, more research has to be done in order to establish a causal link between the two factors.
"It is possible that some of the skeletal muscle losses may also translate to muscle loss in the heart, and the mechanism through which this happens may be similar, but we need more work to prove that," said Prof Koh.
The researchers will be following up with the cohort participants to better understand the impact of this "cardio-sarcopenia" syndrome in the ageing population.
This includes evaluating possible solutions that may prevent or slow down the progression of this syndrome, such as through exercise.
As studies have shown that exercise promotes healthy ageing of the skeletal muscle, Prof Koh recently tested a 12-week specialised exercise programme on 30 participants to see if it decelerates heart ageing and benefits overall health.
A subsequent research report with the findings will likely be available in a few years' time, she said.
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