Effects of two-year adapted physical exercise program and nutritional counselling on cardio-sarcopenia syndrome in older adults with low muscle function

Frail, sarcopenic older individuals have high risk of cardiovascular events and require multidomain interventions. The cross-talk between cardiac and skeletal muscle mass is crucial to maintain physical independence in this specific population. The aim of the study was to evaluate, in a selected sample of frail, sarcopenic older adults, the influence of a two-year multimodal intervention, composed by exercise program and nutritional counseling, compared to a lifestyle education program, on echocardiographic parameters and the relationship between left ventricular mass and skeletal muscle. One-hundred subjects, among those enrolled in the SPRINTT trial at Frailty Clinic of the University-Hospital of Parma, underwent cardiac examination as part of the ancillary protocol CARDIOSPRINTT. Eighty-two participants completed the protocol and attended the final visit after approximately 25 months from enrolment. We did not find significant changes in the intervention group compared with the control one. However, we captured the longitudinal effects of cardiovascular aging, including the reduction of left ventricular volumes and an impairment of systolic and diastolic function of both ventricles. We found a significant relationship between left ventricular mass and skeletal muscle mass, suggesting the existence of cardiac-skeletal muscle axis. This relationship was not independent of age, body mass index or systolic blood pressure. Our findings suggest that among frail, sarcopenic patients with different degree of mobility impairment, a multimodal intervention is necessary to improve cardiac health and counteract the cardiovascular aging. Modulating the cardiac-skeletal muscle axis may represent a novel and promising target for preventing cardio-sarcopenia.