ULTRASOUND OF QUADRICEPS FEMORIS AS A RULE-OUT TOOL FOR MALNUTRITION SCREENING IN HEART FAILURE CLINICS

Aims: To assess the reproducibility and repeatability of quadriceps femoris muscle (QFM) thickness measured by 2D ultrasound (US) and evaluate its potential as a tool to detect the risk of malnutrition in heart failure (HF) outpatients. Methods: Thirty HF participants (malnourished n=16; well-nourished n=14) were recruited. Malnutrition was assessed using the GLIM tool (reference method). QFM thickness was measured at two points (mid-point and 2/3-point). We conducted paired T-tests to assess differences in QFM thickness according to leg side (left vs. right), condition of measurement (with vs. without probe pressure), and inter- and intra-operator. Intraclass correlation coefficients (ICC) were used to test intra- and inter-operator agreement. Results: Analyses showed no differences for most comparisons (total of 48). The midpoint was different in 4 comparisons; 2/3 point for none. ICC analyses ranged from 0.943 to 0.996 for intra- and inter-operator analyses. The best result from the ROC analyses was for the 2/3 QFM point with no probe pressure (AUC 0.74), with a specificity of 43% and sensitivity of 100%. Conclusion: Our preliminary results suggest that 2D US QFM thickness, measured at the two-thirds point without pressure, is a reproducible and repeatable measurement. QFM thickness also showed good ability to differentiate between nutritional statuses and to rule out malnutrition (high sensitivity). These findings indicate it as a practical initial screening tool for identifying patients who do not need further investigation. However, these preliminary findings need to be confirmed in a larger sample of patients.