Table 1_Application and evidence gaps of sarcopenia diagnostic criteria in patients with heart failure: a scoping review.docx

Only 3 studies performed head-to-head comparisons. Heart failure-specific factors (edema interference, New York Heart Association [NYHA] class limitation, timing of assessment in acute phase) received limited attention. No study assessed sarcopenia at acute decompensation before diuresis.

One study evaluated patients with stage B HF, generally considered pre-HF, and was interpreted separately. Eleven studies reported prognostic associations, yet only 1 reported discrimination and reclassification metrics such as concordance index (C-index), net reclassification improvement (NRI), and integrated discrimination improvement (IDI). External validation of diagnostic and prognostic performance was insufficient.</p>Conclusion<p>Current evidence does not support a unified heart failure-specific diagnostic framework for sarcopenia.

Future work should include multicenter prospective cohort studies to establish HF-specific cut-off values, develop assessment protocols for acute decompensated HF and NYHA class IV patients, and conduct large-sample external validation of diagnostic and prognostic performance.</p>