Document Detail


Prediction of mortality in chronic heart failure from peak oxygen consumption adjusted for either body weight or lean tissue.
MedLine Citation:
PMID:  15470653     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Peak oxygen consumption (pVO2) reflects oxygen extraction from the skeletal muscles, but is routinely corrected for body weight. We hypothesized that correcting pVO2 for lean tissue rather than total body weight would improve the prediction of prognosis in patients with chronic heart failure (CHF). METHODS AND RESULTS: A total of 272 CHF outpatients (mean age 61 +/- 12 years, New York Heart Association [NYHA] class 2.3 +/- 0.8) underwent a cardiopulmonary exercise testing and body composition assessment by dual-energy X-ray absorptiometry. During a median follow-up of 608 days (range 8-3656), 75 patients died. Univariate survival analysis showed strong survival prediction from pVO2 adjusted for total weight or lean tissue (chi2 17.7, P < .001; chi2 27.5, P < .0001, respectively). Both predicted survival significantly in bivariate analysis, (chi2 4.6, P = .032; chi2 16.6, P < .0001). The predictive effects were independent of exercise protocol (treadmill versus cycle ergometer) (both P < .001). Multivariate analysis showed that pVO2 adjusted for lean tissue had prognostic importance independently of NYHA class, ejection fraction, and ventilation and carbon dioxide production slope (P < .05 for each). In patients with NYHA class I and II (n = 160), pVO2 adjusted for lean tissue predicted outcome (P = .03). CONCLUSION: Adjustment for lean tissue instead for body weight increases the prognostic power of pVO2, particularly in patients with mild heart failure.
Authors:
Mariantonietta Cicoira; Constantinos H Davos; Darrel P Francis; Wolfram Doehner; Luisa Zanolla; Lorenzo Franceschini; Massimo F Piepoli; Andrew J S Coats; Piero Zardini; Philip A Poole-Wilson; Stefan D Anker
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of cardiac failure     Volume:  10     ISSN:  1071-9164     ISO Abbreviation:  J. Card. Fail.     Publication Date:  2004 Oct 
Date Detail:
Created Date:  2004-10-07     Completed Date:  2005-06-23     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9442138     Medline TA:  J Card Fail     Country:  United States    
Other Details:
Languages:  eng     Pagination:  421-6     Citation Subset:  IM    
Affiliation:
Divisione Clinicizzata di Cardiologia, Università degli Studi di Verona, Italy.
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MeSH Terms
Descriptor/Qualifier:
Absorptiometry, Photon
Area Under Curve
Body Composition
Body Weight*
Chronic Disease
Exercise Test
Exercise Tolerance
Female
Follow-Up Studies
Heart Failure / metabolism*,  mortality*,  physiopathology
Humans
Male
Middle Aged
Oxygen Consumption*
Prognosis
Proportional Hazards Models
ROC Curve
Survival Analysis

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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