Design, rationale, and baseline characteristics of the SONIC-HF multicenter registry

Background 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 HF patients 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 (IQR 74–86) years, 57.6% female, 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.