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Am Heart J. 2009 Oct;158(4 Suppl):S31-6. doi: 10.1016/j.ahj.2009.07.016.

The relationship between body mass index and cardiopulmonary exercise testing in chronic systolic heart failure.

Collaborators (304)

O'Connor CM, Lee KL, Ellis SJ, Rendall DS, Whellan DJ, Piña IL, Keteyian SJ, Cooper LS, Boineau R, Fine LJ, Fleg JL, Leifer ES, Erickson V, Howlett JG, Miller NH, Isaac D, McKelvie R, Zannad F, Boozer S, Connolly P, Doll A, Ellis SJ, Frazier C, Mark D, McClanahan-Crowder M, Meyer M, Mickley BS, Rendall DS, Rich M, Rostami H, Settles S, Spinella K, Staib J, Thompson O, Abraham W, Biniakiewicz D, Homan J, Bittner V, Fitz-Gerald M, Ewald G, Craddock H, Flanagan J, Fonarow G, Erickson V, Colucci W, Lim NZ, Tokareva E, Alharethi R, Hershberger R, Nauman D, Keteyian SJ, Saval M, Kitzman DW, Fray BL, Moore B, Piña IL, Vest M, Smith A, Snell G, Wolfel E, Cantu M, Adams K, Glotzer J, Johnson V, Schumacher K, Blackburn G, Geither C, Moore S, Chandler AB Jr, Vaughn SB, Easler PJ, Williams D, Colmer M, Gardin JM, Dimick K, Sklar SK, Teller S, Ghali JK, Hale-Stenson K, Gheorghiade M, Strzelczyk T, Johnson MR, Vander Ark C, Goldberg LR, Kao A, Dekerlegand J, Kraus WE, Johnson J, Duscha BD, Mehra MR, Ventura H, Harris B, Colvin-Adams M, Duderstadt K, Meyer K, Steger M, Cabuay B, Oren R, Scovel P, Kao A, Stevens T, Haffey K, Mandacina C, Stewart A, Swank AM, Manire J, Thompson PD, Cosio-Lima L, Lagasse M, Naz T, Wagoner L, Roll SK, Yanowitz FG, Walker J, Mueller A, McCullough P, Coleman C, Dorrell KA, Washington T, Handberg E, Hill JA, Bakos J, Boyette A, Smith P, Williams C, Badenhop D, Schroeder S, Walter K, Kokkinos P, Collins E, Korsak L, Eichhorn E, Leonard A, Worley T, Fletcher G, Peasley P, Oldano P, Kostis J, Cosgrove NM, Thadani U, Rogan L, Thresher M, Turner J, Barnard D, Herman D, Contasti A, Sagerian M, Ofili E, Onwuanyi A, Nkemdiche S, Eisen H, Fitzpatrick J, Wald J, Wong J, Ellestad M, Kern L, Amsterdam EA, Burns MJ, Fedson S, Garg RK, Bennett P, Bond L, Chen L, Schrack J, Pearce D, Bond L, Palevo G, Serfass M, Forman D, Lopez MM, Talabi-Oates Y, Williams A, Truitte D, Baumann C, Adams J, Lawrence A, McNamara D, Gruendler E, Schneider V, Hutchins S, Hartwick A, Campbell P, Esposito M, Buchter C, Letterer RA, Taylor R, Wells C, Johnson B, Kaping B, Leathes S, O'Bryan J, Langley L, Hastings ET, Clancy C, Agruss N, Lawless C, Fortman R, McConnell TR, Wantz D, Walsh MN, Margiotti R, Russell S, Heck E, Lachmann J, Lippman D, McLaughlin J, Landzberg J, Mathus S, Cullinane DW, Voyles W, Lenz D, Kaczkowski S, David JL, Gillespie E, Keane-Richmond P, Krueger SK, Heiss L, Gottlieb S, Greenberg N, Gordon N, Parks E, Willoughby M, Kronenberg MW, Glenn J, Madison C, Arnold M, Smith JK, Azevedo E, Drobot G, Estrella-Holder E, Howlett J, Cooley-Warnell D, Yarn S, Isaac D, Grant J, Lyzun K, LeBlanc MH, Vienneau R, McKelvie RS, Beare L, Hancock J, Moe G, Golob D, Melvin K, Cymet A, Renton J, Nigam A, LaLonge J, Djaballah K, Aebehard P, Iliou MC, Sabatier R, Belin A, Cohen-Solal A, Hittinger L, Pitt B, Ades PA, Basta LL, Froelicher V, Hamel ME, Massie BM, Moyé L, Powell LH, Kraus WE, Johnson J, Piner L, Bensimhon D, Russell S, Gardin JM, Bess RL, Cohen GI, Keteyian SJ, Ehrman JK, Brawner CA, Miller NH, Blumenthal JA, Barbour K, Spruill TM, Marcus B, Raczynski J, Adams K, Donahue M, Felker M, Schulman KA, Weinfurt KP, Flynn KE, Reed S, Burnette A, Davidson-Ray L, Friedman JY, Li Y, Lin L, O'Neal B, Zile M, Johnson RH, Bensimhon DR, Bittner V, Boineau R, Dunlap ME, Kraus WE, O'Connor CM, Moe G, Wertheimer J, Whellan DJ.

Author information

1
Ronald Reagan-UCLA Medical Center, Los Angeles, CA 90095-1679, USA.

Abstract

BACKGROUND:

Cardiopulmonary exercise testing (CPX) in patients with systolic heart failure (HF) is important for determining HF prognosis and helping guide timing of heart transplantation. Although approximately 20% to 30% of patients with HF are obese (body mass index [BMI] >30 kg/m(2)), the impact of BMI on CPX results is not well established. The objective of this study was to assess the relationship between BMI and CPX variables, including peak oxygen uptake (VO(2)) at ventilatory threshold, oxygen pulse, and ventilation-carbon dioxide production ratio.

METHODS:

Consecutive patients with systolic HF (n = 2,324) enrolled in the Heart Failure and A Controlled Trial Investigating Outcomes of Exercise Training trial who had baseline BMI recorded were included in this study. Subjects were divided into strata based on BMI: underweight (BMI <18.5 kg/m(2)), normal weight (BMI 18.5-24.9 kg/m(2)), overweight (BMI 25.0-29.9 kg/m(2)), obese I (BMI 30-34.9 kg/m(2)), obese II (BMI 35-39.9 kg/m(2)), and obese III (BMI > or = 40 kg/m(2)).

RESULTS:

Obese III, but not overweight; obese I; or obese II was associated with decreased peak VO(2) (mL kg(-1) min(-1)) compared to normal weight status. Increasing BMI category was inversely related to ventilation/carbon dioxide production (V(E)/V(CO2)) ratio (P < .0001). On multivariable analysis, BMI was a significant independent predictor of peak VO(2) (partial R(2) = 0.07, P < .0001) and V(E)/V(CO2) slope (partial R(2) = 0.03, P < .0001) in patients with chronic systolic HF.

CONCLUSIONS:

Body mass index is significantly associated with key CPX fitness variables in patients with HF. The influence of BMI on the prognostic value of CPX in HF requires further evaluation in longitudinal studies.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT00047437.

PMID:
19782786
PMCID:
PMC2762950
DOI:
10.1016/j.ahj.2009.07.016
[Indexed for MEDLINE]
Free PMC Article

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