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J Am Coll Cardiol, 2001; 37:2080-2085 © 2001 by the American College of Cardiology Foundation |


a Divisione Clinicizzata di Cardiologia, Università degli Studi di Verona, Verona, Italy
Clinica Geriatrica, Università degli Studi di Verona, Verona, Italy
Manuscript received December 1, 2000; revised manuscript received February 26, 2001, accepted March 22, 2001.
Reprint requests and correspondence: Dr. Mariantonietta Cicoira, Divisione Clinicizzata di Cardiologia, Ospedale Civile Maggiore, P.le Stefani, 1 37126 Verona, Italy
mariantonietta.cicoira{at}univr.it
OBJECTIVES
We sought to assess whether skeletal muscle mass might be a predictor of peak oxygen consumption (VO2) and relation of the ventilation to carbon dioxide production (VE/VCO2) slope in patients with chronic heart failure (CHF) independent of clinical conditions, neurohormonal activation and resting hemodynamics.
BACKGROUND
A variety of abnormalities characterize skeletal muscle and contribute to exercise intolerance in patients with CHF. Skeletal muscle mass is a determinant of peak VO2 both in healthy patients and in patients with CHF, but there are no reports on the independent predictive value of this parameter, which can be measured with great accuracy by whole-body dual energy X-ray absorptiometry (DEXA). The influence of skeletal muscle mass on VE/VCO2 slope is not known either.
METHODS
We prospectively evaluated 120 consecutive noncachectic patients with CHF. Every patient underwent a cardiopulmonary exercise test, an echo-Doppler examination and an evaluation of neurohormonal activation and body composition as assessed by DEXA.
RESULTS
At the univariate analysis, New York Heart Association (NYHA) class (p < 0.0001), age (p < 0.0001), male gender (p < 0.0001) and plasma renin (p < 0.0001) significantly related with peak VO2. There was a significant correlation between lean mass and absolute peak VO2 (r = 0.70, p < 0.0001) and VE/VCO2 slope (r = 0.27; p < 0.01). At the multivariate analysis, lean mass predicted peak VO2 and VE/VCO2 slope independently of NYHA functional class, age, gender, neurohormonal activation and resting hemodynamics.
CONCLUSIONS
Skeletal muscle mass is an independent predictor of peak VO2 and VE/VCO2 slope in stable noncachectic patients with CHF. Future studies will determine whether an increase in skeletal muscle mass in the individual patient might result in an improvement in parameters of exercise capacity.
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