Body composition and maximal exercise capacity after heart transplantation.
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State: Public
Version: author
License: CC BY-NC 4.0
Serval ID
serval:BIB_8633E18EB7A7
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Body composition and maximal exercise capacity after heart transplantation.
Journal
ESC heart failure
ISSN
2055-5822 (Electronic)
ISSN-L
2055-5822
Publication state
Published
Issued date
02/2022
Peer-reviewed
Oui
Volume
9
Number
1
Pages
122-132
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Publication Status: ppublish
Abstract
Maximal exercise capacity as measured by peak oxygen consumption (pVO <sub>2</sub> ) 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 pVO <sub>2</sub> during the first decade post-transplant.
Body composition was determined by dual-energy X-ray absorptiometry (DXA) and pVO <sub>2</sub> 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 pVO <sub>2</sub> 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. pVO <sub>2</sub> 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 = VO <sub>2</sub> 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 height <sup>2</sup> (FMI) always remained elevated (>8.8 kg/m <sup>2</sup> ). ALM normalized to body mass index increased from 0.690 (0.188) to 0.848 (0.204) m <sup>2</sup> (P = 0.02) between Periods 1 and 4, explaining 45% of the variance of pVO <sub>2</sub> (R <sup>2</sup> = 0.455; P < 0.001). Eighty-one per cent of the variance of pVO <sub>2</sub> (R <sup>2</sup> = 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).
After heart transplantation, the beneficial effect of peripheral skeletal muscle gain on pVO <sub>2</sub> 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.
Body composition was determined by dual-energy X-ray absorptiometry (DXA) and pVO <sub>2</sub> 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 pVO <sub>2</sub> 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. pVO <sub>2</sub> 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 = VO <sub>2</sub> 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 height <sup>2</sup> (FMI) always remained elevated (>8.8 kg/m <sup>2</sup> ). ALM normalized to body mass index increased from 0.690 (0.188) to 0.848 (0.204) m <sup>2</sup> (P = 0.02) between Periods 1 and 4, explaining 45% of the variance of pVO <sub>2</sub> (R <sup>2</sup> = 0.455; P < 0.001). Eighty-one per cent of the variance of pVO <sub>2</sub> (R <sup>2</sup> = 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).
After heart transplantation, the beneficial effect of peripheral skeletal muscle gain on pVO <sub>2</sub> 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.
Keywords
Body composition, Heart transplant, Maximal exercise capacity, Peak oxygen consumption
Pubmed
Web of science
Open Access
Yes
Create date
10/12/2021 18:21
Last modification date
25/07/2022 6:37