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

Purpose Frail and sarcopenic older individuals are high-risk population of cardiovascular events requiring multidomain intervention. 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 and sarcopenic older adults, the influence of two-year exercise program and nutritional counseling (MCI group) compared to lifestyle education (HALE group) on echocardiographic parameters and on the relationship between cardiac and skeletal muscle mass. Methods One-hundred subjects, among those enrolled in the SPRINTT trial at Frailty Clinic of University-Hospital of Parma site, underwent cardiological examination as part of the ancillary protocol (CARDIOSPRINTT). 82 participants (46 MCI and 36 HALE) completed the protocol and attended the final visit after approximately 25 months. Results We did not find not significant changes in the intervention group compared with HALE group. However, we captured the longitudinal effects of CV aging, including the reduction of left ventricular volume and an impairment of systolic and diastolic function of both ventricles. We found, as in the baseline, a significant relationship between LVM and SMM (r=0.571, p<0.001) suggesting the existence of cardiac muscle-skeletal muscle axis. This relationship was not independent of age, BMI or systolic blood pressure. Conclusion Our findings suggest that among frail patients with different degree of mobility impairment a personalized exercise protocol is necessary to improve cardiac health and counteract the cardiovascular aging. The modulation of cardiac-muscle axis, is an intriguing target for preventing or delaying the cardio-sarcopenia.