Diagnostic Role of Various Short-Chain Fatty Acids in Blood of Patients with Chronic Heart Failure Complicated by Sarcopenia

Aim : to investigate the levels of various short-chain fatty acids (SCFAs) in the blood of patients with chronic heart failure (CHF) complicated by sarcopenia and to analyze their associations with clinical parameters of CHF and sarcopenia. Materials and methods . This study included 76 patients with CHF (mean age — 68.0 ± 9.8 years). Plasma levels of SCFAs (e.g., acetic, propionic, and butyric acids) were determined using electrospray ionization mass spectrometry (ESI-MS). Sarcopenia was diagnosed according to the EWGSOP2 algorithm, which included assessments of muscle strength (mechanical dynamometry), muscle mass (bioimpedance analysis), and muscle function (SPPB tests). Results . The plasma concentrations of butyric acid (C4) were on average 15,050 ng/mL (95% CI: 12,525–18,200) in patients without sarcopenia and 16,400 ng/mL (95% CI: 10,100–20,850) in patients with sarcopenia (p = 0.00003). Pentanoic acid (C5) levels were significantly lower: 472.0 ng/mL (95% CI: 368.2–551.2) in patients without sarcopenia versus 439.0 ng/mL (95% CI: 348.0–514.5) in patients with sarcopenia (p = 0.00001). Four distinct clusters of CHF patients were identified based on their clinical, laboratory, and SCFA profiles. These clusters reflected differences in the severity of CHF, the presence of sarcopenia, physical activity levels, and SCFA concentrations. The most pronounced differences in SCFA levels were observed between Clusters 2 and 3 (C4 levels: 18,650 ng/mL (95% CI: 14,950–21,950) and 10,600 ng/mL (95% CI: 9,220–12,600), respectively). Conclusions . Differences in SCFA levels between clusters indicate potential links between SCFA metabolism, CHF, and sarcopenia progression. These differences may serve as biomarkers for identifying patients at high risk for sarcopenia and highlight the need for an individualized treatment approach, including SCFA metabolism and gut microbiota modulation.