Prediction of mortality in chronic heart failure from peak oxygen consumption adjusted for either body weight or lean tissue

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

doi:10.1016/j.cardfail.2003.12.009

Prediction of mortality in chronic heart failure from peak oxygen consumption adjusted for either body weight or lean tissue

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

Faculty of Medicine and Health Sciences

Research output: Contribution to journal › Article

38 Citations (Scopus)

Abstract

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 (χ2 17.7, P<.001; χ2 27.5, P<.0001, respectively). Both predicted survival significantly in bivariate analysis, (χ2 4.6, P = .032; χ2 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.

Original language	English
Pages (from-to)	421-426
Number of pages	6
Journal	Journal of Cardiac Failure
Volume	10
Issue number	5
DOIs	https://doi.org/10.1016/j.cardfail.2003.12.009
Publication status	Published - 2004

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10.1016/j.cardfail.2003.12.009

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Cicoira, M., Davos, C. H., Francis, D. P., Doehner, W., Zanolla, L., Franceschini, L., Piepoli, M. F., Coats, A. J. S., Zardini, P., Poole-Wilson, P. A., & Anker, S. D. (2004). Prediction of mortality in chronic heart failure from peak oxygen consumption adjusted for either body weight or lean tissue. Journal of Cardiac Failure, 10(5), 421-426. https://doi.org/10.1016/j.cardfail.2003.12.009

@article{c37804e4034f4778acfbbf2c42dd2940,

title = "Prediction of mortality in chronic heart failure from peak oxygen consumption adjusted for either body weight or lean tissue",

abstract = "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 (χ2 17.7, P<.001; χ2 27.5, P<.0001, respectively). Both predicted survival significantly in bivariate analysis, (χ2 4.6, P = .032; χ2 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.",

author = "Mariantonietta Cicoira and Davos, {Constantinos H.} and Francis, {Darrel P.} and Wolfram Doehner and Luisa Zanolla and Lorenzo Franceschini and Piepoli, {Massimo F.} and Coats, {Andrew J. S.} and Piero Zardini and Poole-Wilson, {Philip A.} and Anker, {Stefan D.}",

year = "2004",

doi = "10.1016/j.cardfail.2003.12.009",

language = "English",

volume = "10",

pages = "421--426",

journal = "Journal of Cardiac Failure",

issn = "1071-9164",

publisher = "Churchill Livingstone",

number = "5",

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Cicoira, M, Davos, CH, Francis, DP, Doehner, W, Zanolla, L, Franceschini, L, Piepoli, MF, Coats, AJS, Zardini, P, Poole-Wilson, PA & Anker, SD 2004, 'Prediction of mortality in chronic heart failure from peak oxygen consumption adjusted for either body weight or lean tissue', Journal of Cardiac Failure, vol. 10, no. 5, pp. 421-426. https://doi.org/10.1016/j.cardfail.2003.12.009

TY - JOUR

T1 - Prediction of mortality in chronic heart failure from peak oxygen consumption adjusted for either body weight or lean tissue

AU - Cicoira, Mariantonietta

AU - Davos, Constantinos H.

AU - Francis, Darrel P.

AU - Doehner, Wolfram

AU - Zanolla, Luisa

AU - Franceschini, Lorenzo

AU - Piepoli, Massimo F.

AU - Coats, Andrew J. S.

AU - Zardini, Piero

AU - Poole-Wilson, Philip A.

AU - Anker, Stefan D.

PY - 2004

Y1 - 2004

N2 - 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 (χ2 17.7, P<.001; χ2 27.5, P<.0001, respectively). Both predicted survival significantly in bivariate analysis, (χ2 4.6, P = .032; χ2 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.

AB - 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 (χ2 17.7, P<.001; χ2 27.5, P<.0001, respectively). Both predicted survival significantly in bivariate analysis, (χ2 4.6, P = .032; χ2 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.

U2 - 10.1016/j.cardfail.2003.12.009

DO - 10.1016/j.cardfail.2003.12.009

M3 - Article

VL - 10

SP - 421

EP - 426

JO - Journal of Cardiac Failure

JF - Journal of Cardiac Failure

SN - 1071-9164

IS - 5

ER -