Skeletal Muscle Mass Independently Predicts Peak Oxygen Consumption and Ventilatory Response During Exercise in Noncachectic Patients with Chronic Heart Failure

Objectives.We sought to assess whether skeletal muscle mass might be a predictor of peak oxygen consumption (VO 2 ) and relation of the ventilation to carbon dioxide production (VE/VCO 2 ) slope in patients with chronic heart failure (HF) independent of clinical conditions, neurohormonal activation, and resting hemodynamics.Background.A variety of abnormalities characterize skeletal muscle and contribute to exercise intolerance in patients with chronic HF.Skeletal muscle mass is a determinant of peak VO 2 both in healthy patients and in patients with chronic HF, but there are no reports on the independent predictive value of this parameter, which can be measured with great accuracy by whole-body, dual-energy x-ray absorptiometry (DEXA).The influence of skeletal muscle mass on VE/VCO 2 slope is not known, either.Methods.We prospectively evaluated 120 consecutive noncachectic patients with chronic HF.Every patient underwent a cardiopulmonary exercise test, an echo-Doppler examination, and an evaluation of neurohormonal activation and body composition as assessed by DEXA.Results.At the univariate analysis, New York Heart Association (NYHA) class (p<0.0001),age (p<0.0001),male gender (p<0.0001), and plasma renin (p<0.0001)significantly related with peak VO 2 .There was a significant correlation between lean mass and absolute peak VO 2 (r=0.70;p<0.0001) and VE/VCO 2 slope (r = -0.27;p<0.01).At the multivariate analysis, lean mass predicted peak VO 2 and VE/VCO 2 slope independently of NYHA functional class, age, gender, neurohormonal activation, and resting hemodynamics.Conclusions.Skeletal muscle mass is an independent predictor of peak VO 2 and VE/VCO 2 slope in stable, noncachectic patients with chronic HF.Future studies will determine whether an increase in skeletal muscle mass in the individual patient might result in an improvement in parameters of exercise capacity.-CicoiraM, Zanolla L, Franceschini L, et al.Skeletal muscle mass independently predicts peak oxygen consumption and ventilatory response during exercise in noncachectic patients with chronic heart failure.