Background: Frailty syndrome significantly worsens the prognosis of elderly people. Sarcopenia and malnutrition are integral parts of aging, but there is a lack of knowledge about the overlap of these states, as well as their diagnostic methods and treatments. This study aimed to assess the malnutrition and sarcopenia scale in patients with frailty syndrome and the viability of evaluating the concentrations of the following potential biomarkers: albumin, total protein, and fibrinogen. Methods: A total of 170 patients >65 years were assessed for frailty using the Fried frailty scale. The risk of sarcopenia was measured using the SARC-F scale, and the risk of malnutrition was measured using the Mini Nutritional Assessment (MNA) scale. Serum albumin, protein, and fibrinogen levels were measured. The following fat-free body mass and respiratory parameters were measured: peak expiratory flow (PEF) and forced expiratory volume-one second (FEV1). Results: A total of 53 patients were classified as robust (31%), 96 as prefrail (57%), and 21 as frail (12%) according to Fried frailty criteria. Frail patients had significantly reduced serum albumin and increased fibrinogen compared to the prefrail and robust groups (p < 0.05). A total of 38% of frail patients were at risk of sarcopenia, and 52% were at risk of malnutrition. Frail patients had lower PEF and FEV1 values, with decreases in respiratory parameters correlating with fat-free body mass and muscle strength. Conclusions: Frail patients are at substantial risk of malnutrition and sarcopenia. The MNA and SARC-F scales, combined with routine screening of elderly patients with frailty, may effectively identify patients with the highest risk.

. Background: Frailty syndrome significantly worsens the prognosis of elderly people. An integral part of aging is sarcopenia and malnutrition. There is a lack of knowledge about the overlap of these states, as well as diagnostic methods and treatment. Methods: 170 patients >65 years were assessed for frailty using the Fried frailty scale. The risk of sarcopenia was measured using the SARC-F scale, and the risk of malnutrition was measured using the Mini Nutritional Assessment (MNA) scale. Serum albumin, protein, and fibrinogen levels were measured. Fat-free body mass and respiratory parameters were measured: peak expiratory flow (PEF) and forced expiratory volume- one second (FEV1). Results: 53 patients were classified as robust (31%), 96 as prefrail (57%), and 21 as frail (12%). Frail patients had significantly reduced serum albumin and increased fibrinogen compared to the pre-frail and robust groups (p<0.05). 38% of frail patients are at risk of sarcopenia, and 52% are at risk of malnutrition. Frail patients have lower PEF and FEV1 values. The decrease in respiratory parameters correlates with fat-free body mass and muscle strength. Conclusions: Patients with frailty are the group at most significant risk of malnutrition and sarcopenia compared to their healthy peers and patients in the prefrail stage. MNA and SARC-F scales combined with routine screening of elderly patients with frailty may allow for effective identification of patients at risk of malnutrition and sarcopenia.

Background: There exists some inconsistent evidence on the relationship between altered cardiac morphology, its function, and frailty. Therefore, this study aimed to assess the associations among frailty, lean body mass, central arterial stiffness, and cardiac structure and geometry in older people with a normal ejection fraction. Methods: A total of 205 patients >65 years were enrolled into this ancillary analysis of the FRAPICA study and were assessed for frailty with the Fried phenotype scale. Left ventricular dimensions and geometry were assessed with two-dimensional echocardiography. Fat-free mass was measured using three-site skinfold method. Parametric and non-parametric statistics and analysis of covariance were used for statistical calculations. Results: Frail patients were older and women comprised the majority of the frail group. Frail men and women had comparable weight, height, fat-free mass, blood pressure, central blood pressure, and carotid–femoral pulse wave velocity to their non-frail counterparts. There was a linear correlation between the sum of frailty criteria and left ventricular end-diastolic diameter (Spearman R = −0.17; p < 0.05) and relative wall thickness (Spearman R = 0.23; p < 0.05). In the analysis of covariance, frailty and gender were independently associated with left ventricular mass (gender: β of −0.37 and 95% CI of −0.50–−0.24 at p < 0.001), the left ventricular mass index (gender: β of −0.23 and 95% CI of −0.37–−0.09 at p < 0.001), and relative wall thickness (frailty: β of −0.15 and 95% CI of −0.29–−0.01 at p < 0.05; gender: β of 0.23 and 95% CI of 0.09–0.36 at p < 0.01). Frailty was associated with a shift in heart remodeling toward concentric remodeling/hypertrophy. Conclusions: Frailty is independently associated with thickening of the left ventricular walls and a diminished left ventricular end-diastolic diameter, which are features of concentric remodeling or hypertrophy. This association appears to be more pronounced in women. Such adverse cardiac remodeling may represent another phenotypic feature linked to frailty according to the phenotype frailty criteria.

Background: Multimorbidity significantly affects prognosis in patients after transvenous lead extraction (TLE). The CHA₂DS₂-VASc and CHA₂DS₂-VA scores, widely used for stroke risk stratification in atrial fibrillation, include clinical factors that are also associated with long-term mortality. Purpose: To evaluate the usefulness of the CHA₂DS₂-VASc and CHA₂DS₂-VA scores in predicting short- and long-term mortality in patients following non-laser TLE. Methods: This retrospective study included 3822 patients who underwent non-laser TLE between March 2006 and April 2023 at high-volume centres. The median follow-up was 1848 days (Q1-Q3: 815– 3146 days). Patients were stratified into two groups according to CHA₂DS₂-VASc score (< 3 vs. ≥ 3). 30-day, 1-year, and 3-year, and overall follow-up mortality were assessed. Cox proportional hazards models were used to identify independent predictors of death during short and long follow-up. Results: Patients with CHA₂DS₂-VASc ≥ 3 had significantly higher mortality at 30 days 1 year, 3 years, and during overall follow-up compared with those scoring < 3. A cut-off ≥ 3 showed 80.6% sensitivity and 62.3% specificity for predicting 3-year mortality. Mortality increased progressively with higher CHA₂DS₂-VASc scores (Spearman’s r = 0.983, p< 0.001). The multivariate Cox regression demonstrated that number of points on CHA₂DS₂-VASc and CHA₂DS₂-VA scores were independent predictors long-term mortality, alongside Charlson comorbidity index, atrial fibrillation, infective TLE indications, and renal dysfunction. Each 1-point increase in the CHA₂DS₂VA score was associated with an 11.7% increase in the risk of death. In sex-specific analysis, the risk increased by 33.0% per point in females (HR 1.330; p< 0.001) and by 20.6% in males (HR 1.206; p< 0.001). Conclusion: CHA₂DS_2-VASc and CHA₂DS_2-VA score may be a useful tool for predicting the risk of death during long-term observation of patients after TLE. Incorporation of this score into clinical decision-making may improve risk stratification and support individualized management of patients undergoing TLE.

Background: There exists some inconsistent evidence on the relationship between altered cardiac morphology, its function, and frailty. Therefore, this study aimed to assess the associations among frailty, lean body mass, central arterial stiffness, and cardiac structure and geometry in older people with a normal ejection fraction. Methods: A total of 205 patients >65 years were enrolled into this ancillary analysis of FRAPICA study and were assessed for frailty with Fried phenotype scale. Left ventricular dimensions and geometry were assessed with two-dimensional echocardiography. Fat-free mass was measured using three-site skinfold method. Parametric, non-parametric statistics and analysis of covariance were used for statistical calculations. Results: Frail patients were older and women comprised the majority of the frail group. Frail men and women had comparable weight, height, fat-free mass, blood pressure, central blood pressure, and carotid-femoral pulse wave velocity to their non-frail counterparts. There was a linear correlation between the sum of frailty criteria and left ventricular end diastolic diameter (negative) and relative wall thickness (positive). In the analysis of covariance, frailty and gender were independently associated with left ventricular mass, left ventricular mass indexed, and relative wall thickness. Frailty shifts heart remodeling toward concentric remodeling/hypertrophy. Conclusions: Frailty is independently associated with thickening of the left ventricular walls and a diminished left ventricular end-diastolic diameter, leading to concentric remodeling or hypertrophy. This phenomenon is more pronounced in women. This adverse cardiac remodeling may serve as another phenotype feature of frailty according to the phenotype frailty criteria.