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Skeletal Muscle Composition and Its Relation to Exercise Intolerance in Older Patients With Heart Failure and Preserved Ejection Fraction
Open accessAbstract
Exercise intolerance is the primary chronic symptom in heart failure with preserved ejection fraction (HFpEF), the most common form of HF in older patients, however its pathophysiology is not well understood. Recent data suggest that peripheral factors, such as skeletal muscle dysfunction, may be important contributors. Therefore, 38 participants, 23 HFpEF patients (69±7 years) and 15 age-matched healthy controls (HC), underwent magnetic resonance imaging and cardiopulmonary exercise testing to assess for: skeletal muscle (SM), intermuscular fat (IMF), subcutaneous fat (SCF), total thigh, and thigh compartment areas (TC) and peak exercise oxygen consumption (peak VO2). There were no significant inter-group differences in total thigh area, TC, SCF, or SM. However, in HFpEF versus HC, IMF area (35.6±11.5 vs. 22.3±7.6 cm2, p=0.01), percent IMF/TC (26±5 vs. 20±5%, p=0.005), and the ratio of IMF/SM (0.38±0.10 vs. 0.28±0.09, p=0.007) were significantly increased, while percent SM/TC was significantly reduced (70±5 vs. 75 ±5, p=0.009). In multivariate analyses, IMF area (partial r= -0.51, p=0.002) and IMF/SM ratio (partial r= -0.45, p=0.006) were independent predictors of peak VO2 while SM area was not (partial r=-0.14, p=0.43). Thus, older HFpEF patients have greater thigh IMF and IMF/SM ratio compared to HC, and these are significantly related to their severely reduced peak VO2. These data suggest that abnormalities in skeletal muscle composition may contribute to the severely reduced exercise capacity in older HFpEF patients. This implicates potential targets for novel therapeutic strategies in this common, debilitating disorder of older persons.
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Longitudinal study of muscle strength, quality, and adipose tissue infiltration
Delmonico, M. J., Harris, T. B., Visser, M., Park, S. W., Conroy, M. B., Velasquez-Mieyer, P., Boudreau, R., Manini, T. M., Nevitt, M., Newman, A. B., et al. (2009) · The American Journal of Clinical Nutrition · doi:10.3945/ajcn.2009.28047 · Cited by 1,446
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Self-citationVisser, M., Kritchevsky, S. B., Goodpaster, B. H., Newman, A. B., Nevitt, M., Stamm, E., & Harris, T. B. (2002) · Journal of the American Geriatrics Society · doi:10.1046/j.1532-5415.2002.50217.x · Cited by 845
Calorie Restriction Increases Muscle Mitochondrial Biogenesis in Healthy Humans
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Self-citationHaykowsky, M. J., Brubaker, P. H., Stewart, K. P., Morgan, T. M., Eggebeen, J., & Kitzman, D. W. (2012) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2012.02.055 · Cited by 358
Self-citationBeavers, K. M., Beavers, D. P., Houston, D. K., Harris, T. B., Hue, T. F., Koster, A., Newman, A. B., Simonsick, E. M., Studenski, S. A., Nicklas, B. J., et al. (2013) · The American Journal of Clinical Nutrition · doi:10.3945/ajcn.112.047860 · Cited by 259
Self-citationAbnormal Haemodynamic Response to Exercise in Heart Failure with Preserved Ejection Fraction
Bhella, P. S., Prasad, A., Heinicke, K., Hastings, J. L., Arbab-Zadeh, A., Adams-Huet, B., Pacini, E. L., Shibata, S., Palmer, M. D., Newcomer, B. R., et al. (2011) · European Journal of Heart Failure · doi:10.1093/eurjhf/hfr133 · Cited by 238
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Self-citationFat mass loss predicts gain in physical function with intentional weight loss in older adults
Beavers, K. M., Miller, M. E., Rejeski, W. J., Nicklas, B. J., & Kritchevsky, S. B. (2013) · The Journals of Gerontology Series A: Biological Sciences and Medical Sciences · doi:10.1093/gerona/gls092 · Cited by 82
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Cited by
Obokata, M., Reddy, Y. N. V., Pislaru, S. V., Melenovsky, V., & Borlaug, B. A. (2017) · Circulation · doi:10.1161/circulationaha.116.026807 · Cited by 1,179
Phenotype-Specific Treatment of Heart Failure With Preserved Ejection Fraction: A Multiorgan Roadmap
Shah, S. J., Kitzman, D. W., Borlaug, B. A., van Heerebeek, L., Zile, M. R., Kass, D. A., & Paulus, W. J. (2016) · Circulation · doi:10.1161/circulationaha.116.021884 · Cited by 1,003
Self-citationKitzman, D. W., Brubaker, P., Morgan, T., Haykowsky, M., Hundley, G., Kraus, W. E., Eggebeen, J., & Nicklas, B. J. (2016) · JAMA · doi:10.1001/jama.2015.17346 · Cited by 921
Self-citationHeart Failure With Preserved Ejection Fraction In Perspective
Pfeffer, M. A., Shah, A. M., & Borlaug, B. A. (2019) · Circulation Research · doi:10.1161/circresaha.119.313572 · Cited by 837
The pathophysiology of heart failure with preserved ejection fraction
Borlaug, B. A. (2014) · Nature Reviews Cardiology · doi:10.1038/nrcardio.2014.83 · Cited by 726
Metadata
- Authors
- Haykowsky, M. J., Kouba, E. J., Brubaker, P. H., Nicklas, B. J., Eggebeen, J., & Kitzman, D. W.
- Venue
- The American Journal of Cardiology
- Publisher
- Elsevier BV
- Published
- 2014-04
- Volume
- 113
- Issue
- 7
- Pages
- 1211-1216
- ISSN
- 0002-9149 (ISSN-L)
- OpenAlex
- W1970508540
- Cited by
- 249
- References
- 11
- FWCI
- 38.55
- Type
- journal article
- Language
- en
- Open access
- green
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- Haykowsky, M. J., Kouba, E. J., Brubaker, P. H., Nicklas, B. J., Eggebeen, J., & Kitzman, D. W. (2014). Skeletal Muscle Composition and Its Relation to Exercise Intolerance in Older Patients With Heart Failure and Preserved Ejection Fraction. The American Journal of Cardiology. https://doi.org/10.1016/j.amjcard.2013.12.031
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