Design, Rational, and Baseline Characteristics of the SONIC-HF Multicenter Registry

Abstract

Introduction: Skeletal muscle mass and function are crucial for assessing physical frailty, sarcopenia, and cachexia, which significantly impact the prognosis of geriatric patients with heart failure (HF). Ultrasound-based assessment of skeletal muscles offers a non-invasive, real-time alternative to traditional methods. The compariSON of various methods In evaluatIon of sarCopenia in patients with Heart Failure study (SONIC-HF) aimed to evaluate the feasibility and prognostic impact of ultrasound-based muscle assessment in geriatric patients with HF.

Methods: This multicenter, prospective cohort study enrolled patients with HF aged ≥65 years who could ambulate independently at discharge. Certified observers assessed muscle thickness (biceps, quadriceps, rectus femoris, and diaphragm) using ultrasound at rest and during contraction. The primary endpoint was all-cause mortality. Secondary endpoints included HF hospitalization, unplanned hospital visits, and cardiovascular and non-cardiovascular mortality.

Results: Of the 692 enrolled patients (median age 81 [interquartile range 74-86] years, 57.6% women, left ventricular ejection fraction 45% [32%-60%]), ultrasound-based muscle assessments were completed in 606 patients. Interobserver reliability was excellent (intraclass correlation coefficient 0.84-0.99). Median muscle thicknesses at rest and during contraction were: diaphragm 1.9 (1.6-2.3) mm and 2.9 (2.3-3.8) mm; biceps 19.6 (15.9-23.1) mm and 25.3 (21.3-29.5) mm; quadriceps 19.0 (15.0-23.5) mm and 24.8 (19.9-29.5) mm; rectus femoris 9.7 (7.1-12.3) mm and 12.1 (9.6-15.0) mm. The median follow-up time was 733.5 (438-882) days.

Conclusions: The SONIC-HF registry will provide valuable insights into the feasibility and prognostic implications of ultrasound-based muscle assessment in geriatric patients with HF.