Body composition and maximal exercise capacity after heart transplantation
Abstract Aims Maximal exercise capacity as measured by peak oxygen consumption (pVO2) in cardiopulmonary exercise testing (CPET) of heart transplant recipients (HTR) is limited to a 50–70% level of healthy age‐matched controls. This study investigated the relationship between body composition and pV...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2022-02-01
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| Series: | ESC Heart Failure |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/ehf2.13642 |
| _version_ | 1798025976639127552 |
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| author | Julien Regamey Pierre Monney Patrick Yerly Lucie Favre Matthias Kirsch Piergiorgio Tozzi Olivier Lamy Roger Hullin |
| author_facet | Julien Regamey Pierre Monney Patrick Yerly Lucie Favre Matthias Kirsch Piergiorgio Tozzi Olivier Lamy Roger Hullin |
| author_sort | Julien Regamey |
| collection | DOAJ |
| description | Abstract Aims Maximal exercise capacity as measured by peak oxygen consumption (pVO2) in cardiopulmonary exercise testing (CPET) of heart transplant recipients (HTR) is limited to a 50–70% level of healthy age‐matched controls. This study investigated the relationship between body composition and pVO2 during the first decade post‐transplant. Methods and results Body composition was determined by dual‐energy X‐ray absorptiometry (DXA) and pVO2 by CPET in 48 HTR (n = 38 males; mean age 51 ± 12 years). A total of 95 assessments were acquired 1–9 years post‐transplant, and the results of four consecutive periods were compared [Period 1: 1–2 years (n = 25); 2: 3–4 years (n = 23); 3: 5–6 years (n = 23); 4: 7–9 years (n = 24)]. Linear regression analysis analysed the correlation between pVO2 and pairs of appendicular lean mass (ALM) and fat mass (FM). The relation between ALM and daily dose of calcineurin inhibitor (CNI) was explored using partial correlation controlling for age, gender, and height. pVO2 increased from 0.98 (0.34) to 1.35 (0.35) L/min (P < 0.01) between Periods 1 and 4 corresponding to 54.5–63.3% of predicted value. Peak heart rate (HR) raised from 115 ± 19 to 131 ± 23 b.p.m. (P = 0.05), and anaerobic threshold (AT = VO2 achieved at AT) increased from 0.57 (0.18) to 0.83 (0.35) L/min (P < 0.01) between Periods 1 and 3. Median FM normalized to height2 (FMI) always remained elevated (>8.8 kg/m2). ALM normalized to body mass index increased from 0.690 (0.188) to 0.848 (0.204) m2 (P = 0.02) between Periods 1 and 4, explaining 45% of the variance of pVO2 (R2 = 0.455; P < 0.001). Eighty‐one per cent of the variance of pVO2 (R2 = 0.817; P < 0.001) in multiple regression was explained by AT (β = 0.488), ALM (β = 0.396), peak HR (β = 0.366), and FMI (β = −0.181). ALM was negatively correlated with daily CNI dose (partial R = −0.258; P = 0.01). Conclusions After heart transplantation, the beneficial effect of peripheral skeletal muscle gain on pVO2 is opposed by increased FM. Our findings support lifestyle efforts to fight adiposity and CNI dose reduction in the chronic stable phase to favour positive adaptation of peripheral muscle mass. |
| first_indexed | 2024-04-11T18:27:40Z |
| format | Article |
| id | doaj.art-66258336f11e4e0c827553279a4a7705 |
| institution | Directory Open Access Journal |
| issn | 2055-5822 |
| language | English |
| last_indexed | 2024-04-11T18:27:40Z |
| publishDate | 2022-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | ESC Heart Failure |
| spelling | doaj.art-66258336f11e4e0c827553279a4a77052022-12-22T04:09:33ZengWileyESC Heart Failure2055-58222022-02-019112213210.1002/ehf2.13642Body composition and maximal exercise capacity after heart transplantationJulien Regamey0Pierre Monney1Patrick Yerly2Lucie Favre3Matthias Kirsch4Piergiorgio Tozzi5Olivier Lamy6Roger Hullin7Service de Cardiologie, Département Coeur‐Vaisseaux Lausanne University Hospital (CHUV) and University of Lausanne (UNIL) Lausanne SwitzerlandService de Cardiologie, Département Coeur‐Vaisseaux Lausanne University Hospital (CHUV) and University of Lausanne (UNIL) Lausanne SwitzerlandService de Cardiologie, Département Coeur‐Vaisseaux Lausanne University Hospital (CHUV) and University of Lausanne (UNIL) Lausanne SwitzerlandService d'Endocrinologie, Diabétologie et Métabolisme, Département de Médecine Lausanne University Hospital (CHUV) and University of Lausanne (UNIL) Lausanne SwitzerlandService de Chirurgie Cardiaque, Département Cœur‐Vaisseaux Lausanne University Hospital (CHUV) and University of Lausanne (UNIL) Lausanne SwitzerlandService de Chirurgie Cardiaque, Département Cœur‐Vaisseaux Lausanne University Hospital (CHUV) and University of Lausanne (UNIL) Lausanne SwitzerlandCentre des Maladies osseuses, Département de l'Appareil Locomoteur Lausanne University Hospital (CHUV) and University of Lausanne (UNIL) Lausanne SwitzerlandService de Cardiologie, Département Coeur‐Vaisseaux Lausanne University Hospital (CHUV) and University of Lausanne (UNIL) Lausanne SwitzerlandAbstract Aims Maximal exercise capacity as measured by peak oxygen consumption (pVO2) in cardiopulmonary exercise testing (CPET) of heart transplant recipients (HTR) is limited to a 50–70% level of healthy age‐matched controls. This study investigated the relationship between body composition and pVO2 during the first decade post‐transplant. Methods and results Body composition was determined by dual‐energy X‐ray absorptiometry (DXA) and pVO2 by CPET in 48 HTR (n = 38 males; mean age 51 ± 12 years). A total of 95 assessments were acquired 1–9 years post‐transplant, and the results of four consecutive periods were compared [Period 1: 1–2 years (n = 25); 2: 3–4 years (n = 23); 3: 5–6 years (n = 23); 4: 7–9 years (n = 24)]. Linear regression analysis analysed the correlation between pVO2 and pairs of appendicular lean mass (ALM) and fat mass (FM). The relation between ALM and daily dose of calcineurin inhibitor (CNI) was explored using partial correlation controlling for age, gender, and height. pVO2 increased from 0.98 (0.34) to 1.35 (0.35) L/min (P < 0.01) between Periods 1 and 4 corresponding to 54.5–63.3% of predicted value. Peak heart rate (HR) raised from 115 ± 19 to 131 ± 23 b.p.m. (P = 0.05), and anaerobic threshold (AT = VO2 achieved at AT) increased from 0.57 (0.18) to 0.83 (0.35) L/min (P < 0.01) between Periods 1 and 3. Median FM normalized to height2 (FMI) always remained elevated (>8.8 kg/m2). ALM normalized to body mass index increased from 0.690 (0.188) to 0.848 (0.204) m2 (P = 0.02) between Periods 1 and 4, explaining 45% of the variance of pVO2 (R2 = 0.455; P < 0.001). Eighty‐one per cent of the variance of pVO2 (R2 = 0.817; P < 0.001) in multiple regression was explained by AT (β = 0.488), ALM (β = 0.396), peak HR (β = 0.366), and FMI (β = −0.181). ALM was negatively correlated with daily CNI dose (partial R = −0.258; P = 0.01). Conclusions After heart transplantation, the beneficial effect of peripheral skeletal muscle gain on pVO2 is opposed by increased FM. Our findings support lifestyle efforts to fight adiposity and CNI dose reduction in the chronic stable phase to favour positive adaptation of peripheral muscle mass.https://doi.org/10.1002/ehf2.13642Body compositionHeart transplantMaximal exercise capacityPeak oxygen consumption |
| spellingShingle | Julien Regamey Pierre Monney Patrick Yerly Lucie Favre Matthias Kirsch Piergiorgio Tozzi Olivier Lamy Roger Hullin Body composition and maximal exercise capacity after heart transplantation ESC Heart Failure Body composition Heart transplant Maximal exercise capacity Peak oxygen consumption |
| title | Body composition and maximal exercise capacity after heart transplantation |
| title_full | Body composition and maximal exercise capacity after heart transplantation |
| title_fullStr | Body composition and maximal exercise capacity after heart transplantation |
| title_full_unstemmed | Body composition and maximal exercise capacity after heart transplantation |
| title_short | Body composition and maximal exercise capacity after heart transplantation |
| title_sort | body composition and maximal exercise capacity after heart transplantation |
| topic | Body composition Heart transplant Maximal exercise capacity Peak oxygen consumption |
| url | https://doi.org/10.1002/ehf2.13642 |
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