The incremental prognostic importance of body fat adjusted peak oxygen consumption in chronic heart failure

Osman, Ahmed F., Mehra, Mandeep R., Lavie, Carl J., Nunez, Eduardo and Milani, Richard V. (2000). The incremental prognostic importance of body fat adjusted peak oxygen consumption in chronic heart failure. In: 72nd Annual Scientific Session of the American-Heart-Association, Atlanta, GA, United States, (2126-2131). 7-10 November 1999. doi:10.1016/S0735-1097(00)00985-2


Author Osman, Ahmed F.
Mehra, Mandeep R.
Lavie, Carl J.
Nunez, Eduardo
Milani, Richard V.
Title of paper The incremental prognostic importance of body fat adjusted peak oxygen consumption in chronic heart failure
Conference name 72nd Annual Scientific Session of the American-Heart-Association
Conference location Atlanta, GA, United States
Conference dates 7-10 November 1999
Journal name Journal of the American College of Cardiology   Check publisher's open access policy
Place of Publication San Diego, CA, United States
Publisher Elsevier
Publication Year 2000
Sub-type Fully published paper
DOI 10.1016/S0735-1097(00)00985-2
ISSN 0735-1097
1558-3597
Volume 36
Issue 7
Start page 2126
End page 2131
Total pages 5
Language eng
Formatted Abstract/Summary
OBJECTIVES: We sought to assess whether the adjustment of peak oxygen consumption (PkVO2) to lean body mass would yield a more accurate discriminator of outcomes in the chronic heart failure population.

BACKGROUND: Peak oxygen consumption is traditionally used to risk stratify patients with congestive heart failure (CHF) and to time cardiac transplantation. There is, however, considerable variability in body fat content, which represents metabolically inactive mass.

METHODS: In 225 consecutive patients with CHF, the percentage of body fat was determined by the sum of skinfolds technique. All underwent CPX using a ramping treadmill protocol. Mean follow-up duration was 18.9 ± 11.3 months.

RESULTS: There were 14 cardiovascular deaths and 15 transplants. Peak oxygen consumption lean, both as a continuous variable and using a cutoff of ≤19 ml/kg/min, was a better predictor of outcome than unadjusted PkVO2 (p = 0.003 vs. 0.027 for the continuous variables and p = 0.0006 vs. 0.055 for ≤19 ml/kg/min and ≤14 ml/kg/min unadjusted body weight, respectively). Using partial correlation index R statistics, the Cox model using PkVO2 lean ≤19 mVkg/min, in addition to age and etiology of CHF as covariates, yielded the strongest predictive relationship to the combined end point (chi-square value 24.32). Especially in the obese patients and in women, there was considerably better correlation of PkVO2 lean with outcome than the unadjusted PkVO2.

CONCLUSIONS: The adjustment of PkVO2 to lean body mass increases the prognostic value of cardiopulmonary stress testing in the evaluation of patients with chronic heart failure. The use of <19 ml O2/kg of lean body mass/min as a cutoff in PkVO2 should be used for timing transplantation, particularly in women and the obese.
Keyword Peak oxygen consumption
Chronic heart failure
Q-Index Code E1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Conference Paper
Collection: School of Medicine Publications
 
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Created: Mon, 14 Mar 2011, 09:37:59 EST