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August 1, 2026CJC OpenOpen Access

Higher VO2 lean is linked to ~9% lower mortality and HF hospitalization risk in HFpEF.

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Why the study?

It was hypothesized that peak oxygen consumption adjusted for lean body mass (VO2 lean) is a superior independent prognostic predictor in HFpEF compared to traditional CPET measures.

Does VO2 lean measured by CPET predict the composite of all-cause mortality and HF hospitalizations in patients with HFpEF better than traditional CPET measures?

Population

103 outpatient HFpEF patients at a Brazilian tertiary hospital

Comparison

VO2 lean vs traditional CPET measures

Design

Prospective cohort study

Follow-up

Average of 889 days (±291)

Key result

Peak oxygen consumption adjusted for lean body mass (VO2 lean) was an independent predictor of all-cause mortality and heart failure hospitalization in patients with HFpEF (HR 0.912; p<0.025).

Authors

FBFernando Colares BarrosJCJéssica Cristina de CezaroPCPietro Donelli Costa

Discussion

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Member takes

Overview

VO2 lean may aid HFpEF risk stratification; leaves open whether it outperforms standard CPET metrics prospectively.

Study Design

Type

Cohort (n=103)

Multicenter

No

Structured PICO

Does VO2 lean measured by CPET predict the composite of all-cause mortality and HF hospitalizations in patients with HFpEF better than traditional CPET measures?

P
Population
103 outpatients with heart failure with preserved ejection fraction (mean age 69 years) followed for an average of 889 days.
E
Exposure
Measurement of peak oxygen consumption adjusted for lean body mass (VO2 lean) via cardiopulmonary exercise testing (CPET) and bioelectrical impedance analysis.
C
Comparator
Traditional CPET measures
O
Outcome
Composite of all-cause mortality and HF hospitalizationscomposite

Main Result

Hazard Ratio: 0.912

p-value: p=<0.025

VO2 lean measured during cardiopulmonary exercise testing is a strong independent predictor of mortality and heart failure hospitalization in patients with HFpEF, outperforming traditional CPET measures.

Cite This Study

Barros et al. (2026) conducted a cohort in Heart failure with preserved ejection fraction (HFpEF) (n=103). Peak oxygen consumption adjusted for lean body mass (VO2 lean) was evaluated on Composite of all-cause mortality and HF hospitalizations (HR 0.912, p=<0.025). Peak oxygen consumption adjusted for lean body mass (VO2 lean) was an independent predictor of all-cause mortality and heart failure hospitalization in patients with HFpEF (HR 0.912; p<0.025).

synapsesocial.com/papers/6a753a7433d16877c7f565bdhttps://doi.org/10.1016/j.cjco.2026.07.017
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Prognostic Value of Cardiopulmonary Exercise Testing in Heart Failure With Reduced, Midrange, and Preserved Ejection Fraction2017 · 168 citations
  2. 2Cardiopulmonary Exercise Testing as a Prognosis-Assessing Tool in Heart Failure with Preserved Ejection Fraction2025 · 4 citations
  3. 3Prognostic Value of Cardiopulmonary Exercise Testing Parameters in Young Heart Failure Patients with Moderately Reduced Exercise Capacity2026
  4. 4Cardiopulmonary Exercise Testing and HFpEF: Diagnostic and Therapeutic Perspectives2025 · 4 citations
  5. 5Cardiopulmonary Exercise Testing and HFpEF: Diagnostic and Therapeutic Perspectives2025