Low skeletal muscle mass is associated with low aerobic capacity and increased mortality risk in patients with coronary heart disease - A CARE CR Study

Simon Nichols; Alasdair O'Doherty; Claire Taylor; Andrew L. Clark; Sean Carroll; Lee Ingle

doi:10.1111/cpf.12539

Low skeletal muscle mass is associated with low aerobic capacity and increased mortality risk in patients with coronary heart disease - A CARE CR Study

Simon Nichols, Alasdair O'Doherty, Claire Taylor, Andrew L. Clark, Sean Carroll, Lee Ingle

Sport Exercise and Rehabilitation Department

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Abstract

Background: In patients with chronic heart failure, there is a positive linear relationship between skeletal muscle mass (SMM) and peak oxygen consumption ((Formula presented.) O _2peak ); an independent predictor of all-cause mortality _. We investigated the association between SMM and (Formula presented.) O _2peak in patients with coronary heart disease (CHD) without a diagnosis of heart failure. Methods: Male patients with CHD underwent maximal cardiopulmonary exercise testing and dual X-ray absorptiometry assessment. (Formula presented.) O _2peak, the ventilatory anaerobic threshold and peak oxygen pulse were calculated. SMM was expressed as appendicular lean mass (lean mass in both arms and legs) and reported as skeletal muscle index (SMI; kg m ⁻² ), and as a proportion of total body mass (appendicular skeletal mass [ASM%]). Low SMM was defined as a SMI <7·26 kg m ⁻² , or ASM% <25·72%. Five-year all-cause mortality risk was calculated using the Calibre 5-year all-cause mortality risk score. Results: Sixty patients were assessed. Thirteen (21·7%) had low SMM. SMI and ASM% correlated positively with (Formula presented.) O _2peak (r = 0·431 and 0·473, respectively; P<0·001 for both). SMI and ASM% predicted 16·3% and 12·9% of the variance in (Formula presented.) O _2peak , respectively. SMI correlated most closely with peak oxygen pulse (r = 0·58; P<0·001). SMI predicted 40·3% of peak (Formula presented.) O ₂ /HR variance. ASM% was inversely associated with 5-year all-cause mortality risk (r = −0·365; P = 0·006). Conclusion: Skeletal muscle mass was positively correlated with (Formula presented.) O _2peak in patients with CHD. Peak oxygen pulse had the strongest association with SMM. Low ASM% was associated with a higher risk of all-cause mortality. The effects of exercise and nutritional strategies aimed at improving SMM and function in CHD patients should be investigated.

Original language	English
Pages (from-to)	93-102
Number of pages	10
Journal	Clinical Physiology and Functional Imaging
Volume	39
Issue number	1
Early online date	30 Aug 2018
DOIs	https://doi.org/10.1111/cpf.12539
Publication status	Published - Jan 2019

Keywords

cardiorespiratory fitness
coronary disease
sarcopenia
skeletal muscle

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Low skeletal muscle mass is associated with low aerobic capacity and increased mortality risk in patients with coronary heart disease - A CARE CR StudyAccepted author manuscript, 653 KBLicence: Unspecified
Nichols_et_al-2018-Clinical_Physiology_and_Functional_ImagingFinal published version, 220 KBLicence: CC BY

Cite this

@article{b4dd1e0643a745989ef0a95375b0d6c7,

title = "Low skeletal muscle mass is associated with low aerobic capacity and increased mortality risk in patients with coronary heart disease - A CARE CR Study",

abstract = "Background: In patients with chronic heart failure, there is a positive linear relationship between skeletal muscle mass (SMM) and peak oxygen consumption ((Formula presented.) O 2peak ); an independent predictor of all-cause mortality . We investigated the association between SMM and (Formula presented.) O 2peak in patients with coronary heart disease (CHD) without a diagnosis of heart failure. Methods: Male patients with CHD underwent maximal cardiopulmonary exercise testing and dual X-ray absorptiometry assessment. (Formula presented.) O 2peak, the ventilatory anaerobic threshold and peak oxygen pulse were calculated. SMM was expressed as appendicular lean mass (lean mass in both arms and legs) and reported as skeletal muscle index (SMI; kg m −2 ), and as a proportion of total body mass (appendicular skeletal mass [ASM%]). Low SMM was defined as a SMI <7·26 kg m −2 , or ASM% <25·72%. Five-year all-cause mortality risk was calculated using the Calibre 5-year all-cause mortality risk score. Results: Sixty patients were assessed. Thirteen (21·7%) had low SMM. SMI and ASM% correlated positively with (Formula presented.) O 2peak (r = 0·431 and 0·473, respectively; P<0·001 for both). SMI and ASM% predicted 16·3% and 12·9% of the variance in (Formula presented.) O 2peak , respectively. SMI correlated most closely with peak oxygen pulse (r = 0·58; P<0·001). SMI predicted 40·3% of peak (Formula presented.) O 2 /HR variance. ASM% was inversely associated with 5-year all-cause mortality risk (r = −0·365; P = 0·006). Conclusion: Skeletal muscle mass was positively correlated with (Formula presented.) O 2peak in patients with CHD. Peak oxygen pulse had the strongest association with SMM. Low ASM% was associated with a higher risk of all-cause mortality. The effects of exercise and nutritional strategies aimed at improving SMM and function in CHD patients should be investigated.",

keywords = "cardiorespiratory fitness, coronary disease, sarcopenia, skeletal muscle",

author = "Simon Nichols and Alasdair O'Doherty and Claire Taylor and Clark, {Andrew L.} and Sean Carroll and Lee Ingle",

note = "Funding Information: We would like to thank Toni Goodman, Wendy Summer, Lesley Richardson and Emma Smith for their help during patient recruitment. We would also like to acknowledge the support of the Hull and East Riding Cardiac Trust Fund who provided financial support which enabled us to analyse our blood samples. Funding Information: Financial support for blood sample analysis was provided by the Hull and East Riding Cardiac Trust Fund (Hull, East Yorkshire, UK). Funding for a research post (SN) was supported by City Health Care Partnership CIC (Hull, UK). [No Grant Numbers Issued]. Publisher Copyright: {\textcopyright} 2018 The Authors. Clinical Physiology and Functional Imaging published by John Wiley & Sons Ltd on behalf of Scandinavian Society of Clinical Physiology and Nuclear Medicine.",

year = "2019",

month = jan,

doi = "10.1111/cpf.12539",

language = "English",

volume = "39",

pages = "93--102",

journal = "Clinical Physiology and Functional Imaging",

issn = "1475-0961",

publisher = "Blackwell Publishing",

number = "1",

}

TY - JOUR

T1 - Low skeletal muscle mass is associated with low aerobic capacity and increased mortality risk in patients with coronary heart disease - A CARE CR Study

AU - Nichols, Simon

AU - O'Doherty, Alasdair

AU - Taylor, Claire

AU - Clark, Andrew L.

AU - Carroll, Sean

AU - Ingle, Lee

N1 - Funding Information: We would like to thank Toni Goodman, Wendy Summer, Lesley Richardson and Emma Smith for their help during patient recruitment. We would also like to acknowledge the support of the Hull and East Riding Cardiac Trust Fund who provided financial support which enabled us to analyse our blood samples. Funding Information: Financial support for blood sample analysis was provided by the Hull and East Riding Cardiac Trust Fund (Hull, East Yorkshire, UK). Funding for a research post (SN) was supported by City Health Care Partnership CIC (Hull, UK). [No Grant Numbers Issued]. Publisher Copyright: © 2018 The Authors. Clinical Physiology and Functional Imaging published by John Wiley & Sons Ltd on behalf of Scandinavian Society of Clinical Physiology and Nuclear Medicine.

PY - 2019/1

Y1 - 2019/1

N2 - Background: In patients with chronic heart failure, there is a positive linear relationship between skeletal muscle mass (SMM) and peak oxygen consumption ((Formula presented.) O 2peak ); an independent predictor of all-cause mortality . We investigated the association between SMM and (Formula presented.) O 2peak in patients with coronary heart disease (CHD) without a diagnosis of heart failure. Methods: Male patients with CHD underwent maximal cardiopulmonary exercise testing and dual X-ray absorptiometry assessment. (Formula presented.) O 2peak, the ventilatory anaerobic threshold and peak oxygen pulse were calculated. SMM was expressed as appendicular lean mass (lean mass in both arms and legs) and reported as skeletal muscle index (SMI; kg m −2 ), and as a proportion of total body mass (appendicular skeletal mass [ASM%]). Low SMM was defined as a SMI <7·26 kg m −2 , or ASM% <25·72%. Five-year all-cause mortality risk was calculated using the Calibre 5-year all-cause mortality risk score. Results: Sixty patients were assessed. Thirteen (21·7%) had low SMM. SMI and ASM% correlated positively with (Formula presented.) O 2peak (r = 0·431 and 0·473, respectively; P<0·001 for both). SMI and ASM% predicted 16·3% and 12·9% of the variance in (Formula presented.) O 2peak , respectively. SMI correlated most closely with peak oxygen pulse (r = 0·58; P<0·001). SMI predicted 40·3% of peak (Formula presented.) O 2 /HR variance. ASM% was inversely associated with 5-year all-cause mortality risk (r = −0·365; P = 0·006). Conclusion: Skeletal muscle mass was positively correlated with (Formula presented.) O 2peak in patients with CHD. Peak oxygen pulse had the strongest association with SMM. Low ASM% was associated with a higher risk of all-cause mortality. The effects of exercise and nutritional strategies aimed at improving SMM and function in CHD patients should be investigated.

AB - Background: In patients with chronic heart failure, there is a positive linear relationship between skeletal muscle mass (SMM) and peak oxygen consumption ((Formula presented.) O 2peak ); an independent predictor of all-cause mortality . We investigated the association between SMM and (Formula presented.) O 2peak in patients with coronary heart disease (CHD) without a diagnosis of heart failure. Methods: Male patients with CHD underwent maximal cardiopulmonary exercise testing and dual X-ray absorptiometry assessment. (Formula presented.) O 2peak, the ventilatory anaerobic threshold and peak oxygen pulse were calculated. SMM was expressed as appendicular lean mass (lean mass in both arms and legs) and reported as skeletal muscle index (SMI; kg m −2 ), and as a proportion of total body mass (appendicular skeletal mass [ASM%]). Low SMM was defined as a SMI <7·26 kg m −2 , or ASM% <25·72%. Five-year all-cause mortality risk was calculated using the Calibre 5-year all-cause mortality risk score. Results: Sixty patients were assessed. Thirteen (21·7%) had low SMM. SMI and ASM% correlated positively with (Formula presented.) O 2peak (r = 0·431 and 0·473, respectively; P<0·001 for both). SMI and ASM% predicted 16·3% and 12·9% of the variance in (Formula presented.) O 2peak , respectively. SMI correlated most closely with peak oxygen pulse (r = 0·58; P<0·001). SMI predicted 40·3% of peak (Formula presented.) O 2 /HR variance. ASM% was inversely associated with 5-year all-cause mortality risk (r = −0·365; P = 0·006). Conclusion: Skeletal muscle mass was positively correlated with (Formula presented.) O 2peak in patients with CHD. Peak oxygen pulse had the strongest association with SMM. Low ASM% was associated with a higher risk of all-cause mortality. The effects of exercise and nutritional strategies aimed at improving SMM and function in CHD patients should be investigated.

KW - cardiorespiratory fitness

KW - coronary disease

KW - sarcopenia

KW - skeletal muscle

UR - http://www.scopus.com/inward/record.url?scp=85052832016&partnerID=8YFLogxK

U2 - 10.1111/cpf.12539

DO - 10.1111/cpf.12539

M3 - Article

SN - 1475-0961

VL - 39

SP - 93

EP - 102

JO - Clinical Physiology and Functional Imaging

JF - Clinical Physiology and Functional Imaging

IS - 1

ER -

Low skeletal muscle mass is associated with low aerobic capacity and increased mortality risk in patients with coronary heart disease - A CARE CR Study

Abstract

Keywords

UN SDGs

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