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 Clarke, Sean Carroll, Lee Ingle

Research output: Contribution to journalArticlepeer-review

13 Citations (Scopus)
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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 (V̇O2peak); an independent predictor of all-cause mortality. We investigated the association between SMM and V̇O2peak 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. V̇O2peak, the ventilatory anaerobic threshold and peak oxygen pulse (peak V̇O2/HR) were calculated. SMM was expressed as appendicular lean mass (lean mass in both arms and legs) and reported as skeletal muscle index (SMI; kg/m2), and as a proportion of total body mass (appendicular skeletal mass [ASM%]). Low SMM was defined as a SMI<7.26 kg/m2, or ASM% <25.72%). 5-year all-cause mortality risk was calculated using the Caliber 5-year all-cause mortality risk score. Results: Sixty patients were assessed. Thirteen (21.7%) had low SMM. SMI and ASM% correlated positively with V̇O2peak (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 V̇O2peak, respectively. SMI correlated most closely with peak V̇O2/HR (r=0.58; p<0.001). SMI predicted 40.3% of peak V̇O2/HR variance. ASM% was inversely associated with 5-year all-cause mortality risk (r=-0.365; P=0.006). Conclusion: SMM was positively correlated with V̇O2peak in patients with CHD. Peak V̇O2/HR 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 languageEnglish
Pages (from-to)93-102
JournalClinical Physiology and Functional Imaging
Volume39
Issue number1
Early online date30 Aug 2018
DOIs
Publication statusPublished - Jan 2019

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