The combination of obesity and low hemoglobin in heart failure patients was associated with the lowest peak exercise oxygen uptake (13 vs 20 ml/kg/min in non-obese with normal hemoglobin; p<0.001).
Observational (n=315)
Does the combination of obesity and low hemoglobin reduce peak exercise oxygen uptake in adults with heart failure?
The combination of obesity and low hemoglobin significantly impairs peak exercise oxygen uptake in patients with heart failure with reduced ejection fraction.
Tasa de eventos absoluta: 13% vs 20%
valor p: p=<0.001
Background Exercise intolerance, obesity, and low hemoglobin (hemoglobin<13 and <12 g/dl, men/women, respectively) are common features of heart failure. Despite serving as potent contributors to metabolic dysfunction, the impact of obesity and low hemoglobin on exercise intolerance is unknown. This study tested the hypotheses, compared with non-obese (NO) heart failure with normal hemoglobin, (a) counterparts with low hemoglobin and obesity or non-obesity will demonstrate reduced peak exercise oxygen uptake; (b) obese with normal hemoglobin will demonstrate decreased peak exercise oxygen uptake; (c) compared across stratifications, obese with low hemoglobin will demonstrate the sharpest decrement in peak exercise oxygen uptake. Methods Adults with heart failure ( n = 315; left ventricular ejection fraction≤40%; 77% men) (Group 1: normal hemoglobin and non-obese, n = 137; Group 2: low hemoglobin and non-obese, n = 51; Group 3: normal hemoglobin+obesity, n = 89; Group 4, n = 38: low hemoglobin+obesity; body mass index = 26 ± 3, 26 ± 2, 34 ± 4, 34 ± 4 kg/m 2 , respectively) completed treadmill cardiopulmonary exercise testing as part of routine clinical management. Peak exercise oxygen uptake was measured via standard metabolic system. Results There were no group-wise differences for heart failure class, gender, left ventricular ejection fraction, and resting cardiopulmonary function. Group 1 demonstrated increased peak exercise oxygen uptake versus Groups 2–4 (20 ± 6 versus 17 ± 6, 17 ± 5, 13 ± 4 ml/kg/min, respectively; all p < 0.001); whereas Group 4 peak exercise oxygen uptake was reduced versus all groups ( p < 0.001). Additionally, both body mass index (R 2 = 0.10) and hemoglobin (R 2 = 0.12) were significant predictors of peak exercise oxygen uptake in Group 1; which were relationships not mirrored for Groups 2–4. Conclusion These data suggest obesity together with low hemoglobin are potent contributors to impaired peak exercise oxygen uptake and, hence, oxidative metabolic capacity. In diverse populations of heart failure where obesity and/or low hemoglobin are present, it is important to consider these features together when interpreting peak exercise oxygen uptake and underlying exercise limitations.
Iterson et al. (Mon,) conducted a observational in heart failure (n=315). Obesity and low hemoglobin vs. Non-obese with normal hemoglobin was evaluated on Peak exercise oxygen uptake (p=<0.001). The combination of obesity and low hemoglobin in heart failure patients was associated with the lowest peak exercise oxygen uptake (13 vs 20 ml/kg/min in non-obese with normal hemoglobin; p<0.001).