Heart failure patients had significantly lower peak oxygen uptake (WMD -9.96 mL/kg/min; 95% CI -11.71 to -8.21) and reduced lean mass compared with non-HF controls.
Meta-Analysis
Do differences in whole-body and skeletal muscle composition between patients with HF and non-HF controls contribute to reduced peak oxygen uptake (VO2peak)?
Individuals with heart failure display significant abnormalities in body and skeletal muscle composition, including reduced lean mass and oxidative Type I fibres, which negatively impact peak oxygen uptake.
Effect estimate: WMD -9.96 mL/kg/min (95% CI -11.71 to -8.21)
Abstract Aims Heart failure (HF) has a major impact on exercise tolerance that may (in part) be due to abnormalities in body and skeletal muscle composition. This systematic review and meta-analysis aims to assess how differences in whole-body and skeletal muscle composition between patients with HF and non-HF controls (CON) contribute to reduced peak oxygen uptake (VO2peak). Methods and results The PubMed database was searched from 1975 to May 2024 for eligible studies. Cross-sectional studies with measures of VO2peak, body composition, or muscle biopsies in HF and CON were considered. Out of 709 articles, 27 studies were included in this analysis. Compared with CON, VO2peak [weighted mean difference (WMD): −9.96 mL/kg/min, 95% confidence interval (CI): −11.71 to −8.21), total body lean mass (WMD: −1.63 kg, 95% CI: −3.05 to −0.21), leg lean mass (WMD: −1.38 kg, 95% CI: −2.18 to −0.59), thigh skeletal muscle area (WMD: −10.88 cm2 , 95% CI: −21.40 to −0.37), Type I fibres (WMD: −7.76%, 95% CI: −14.81 to −0.71), and capillary-to-fibre ratio (WMD: −0.27, 95% CI: −0.50 to −0.03) were significantly lower in HF. Total body fat mass (WMD: 3.34 kg, 95% CI: 0.35–6.34), leg fat mass (WMD: 1.37 kg, 95% CI: 0.37–2.37), and Type IIx fibres (WMD: 7.72%, 95% CI: 1.52–13.91) were significantly higher in HF compared with CON. Absolute VO2peak was significantly associated with total body and leg lean mass, thigh skeletal muscle area, and capillary-to-fibre ratio. Conclusion Individuals with HF display abnormalities in body and skeletal muscle composition including reduced lean mass, oxidative Type I fibres, and capillary-to-fibre ratio that negatively impact VO2peak.
Schmid et al. (Sat,) conducted a meta-analysis in Heart failure. Heart failure vs. Non-HF controls was evaluated on peak oxygen uptake (VO2peak) (WMD -9.96 mL/kg/min, 95% CI -11.71 to -8.21). Heart failure patients had significantly lower peak oxygen uptake (WMD -9.96 mL/kg/min; 95% CI -11.71 to -8.21) and reduced lean mass compared with non-HF controls.