Peripheral Determinants of Oxygen Utilization in Heart Failure With Preserved Ejection Fraction: Central Role of Adiposity

Payman Zamani; Elizabeth A. Proto; Jeremy A. Mazurek; Stuart B. Prenner; Kenneth B. Margulies; Raymond R. Townsend; Daniel P. Kelly; Zoltan Arany; David C. Poole; Peter D. Wagner; Julio A. Chirinos

doi:10.1016/j.jacbts.2020.01.003

Peripheral Determinants of Oxygen Utilization in Heart Failure With Preserved Ejection Fraction: Central Role of Adiposity

Payman Zamani^*, Elizabeth A. Proto, Jeremy A. Mazurek, Stuart B. Prenner, Kenneth B. Margulies, Raymond R. Townsend, Daniel P. Kelly, Zoltan Arany, David C. Poole, Peter D. Wagner, Julio A. Chirinos

^*Corresponding author for this work

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Abstract

The aim of this study was to determine the arteriovenous oxygen content difference (ΔAVO₂) in adult subjects with and without heart failure with preserved ejection fraction (HFpEF) during systemic and forearm exercise. Subjects with HFpEF had reduced ΔAVO₂. Forearm diffusional conductance for oxygen, a lumped conductance parameter that incorporates all impediments to the movement of oxygen from red blood cells in skeletal muscle capillaries into the mitochondria within myocytes, was estimated. Forearm diffusional conductance for oxygen was not different among adults with HFpEF, those with hypertension, and healthy control subjects; therefore, diffusional conductance cannot explain the reduced forearm ΔAVO₂. Instead, adiposity was strongly associated with ΔAVO₂, suggesting an active role for adipose tissue in reducing exercise capacity in patients with HFpEF.

Original language	English
Pages (from-to)	211-225
Number of pages	15
Journal	JACC: Basic to Translational Science
Volume	5
Issue number	3
Early online date	23 Mar 2020
DOIs	https://doi.org/10.1016/j.jacbts.2020.01.003
Publication status	Published - Mar 2020
Externally published	Yes

Keywords

adiposity
aerobic capacity
exercise
HFpEF
oxygen transport

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Zamani, P., Proto, E. A., Mazurek, J. A., Prenner, S. B., Margulies, K. B., Townsend, R. R., Kelly, D. P., Arany, Z., Poole, D. C., Wagner, P. D., & Chirinos, J. A. (2020). Peripheral Determinants of Oxygen Utilization in Heart Failure With Preserved Ejection Fraction: Central Role of Adiposity. JACC: Basic to Translational Science, 5(3), 211-225. https://doi.org/10.1016/j.jacbts.2020.01.003

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title = "Peripheral Determinants of Oxygen Utilization in Heart Failure With Preserved Ejection Fraction: Central Role of Adiposity",

abstract = "The aim of this study was to determine the arteriovenous oxygen content difference (ΔAVO2) in adult subjects with and without heart failure with preserved ejection fraction (HFpEF) during systemic and forearm exercise. Subjects with HFpEF had reduced ΔAVO2. Forearm diffusional conductance for oxygen, a lumped conductance parameter that incorporates all impediments to the movement of oxygen from red blood cells in skeletal muscle capillaries into the mitochondria within myocytes, was estimated. Forearm diffusional conductance for oxygen was not different among adults with HFpEF, those with hypertension, and healthy control subjects; therefore, diffusional conductance cannot explain the reduced forearm ΔAVO2. Instead, adiposity was strongly associated with ΔAVO2, suggesting an active role for adipose tissue in reducing exercise capacity in patients with HFpEF.",

keywords = "adiposity, aerobic capacity, exercise, HFpEF, oxygen transport",

author = "Payman Zamani and Proto, {Elizabeth A.} and Mazurek, {Jeremy A.} and Prenner, {Stuart B.} and Margulies, {Kenneth B.} and Townsend, {Raymond R.} and Kelly, {Daniel P.} and Zoltan Arany and Poole, {David C.} and Wagner, {Peter D.} and Chirinos, {Julio A.}",

year = "2020",

month = mar,

doi = "10.1016/j.jacbts.2020.01.003",

language = "English",

volume = "5",

pages = "211--225",

journal = "JACC: Basic to Translational Science",

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Zamani, P, Proto, EA, Mazurek, JA, Prenner, SB, Margulies, KB, Townsend, RR, Kelly, DP, Arany, Z, Poole, DC, Wagner, PD & Chirinos, JA 2020, 'Peripheral Determinants of Oxygen Utilization in Heart Failure With Preserved Ejection Fraction: Central Role of Adiposity', JACC: Basic to Translational Science, vol. 5, no. 3, pp. 211-225. https://doi.org/10.1016/j.jacbts.2020.01.003

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T2 - Central Role of Adiposity

AU - Zamani, Payman

AU - Proto, Elizabeth A.

AU - Mazurek, Jeremy A.

AU - Prenner, Stuart B.

AU - Margulies, Kenneth B.

AU - Townsend, Raymond R.

AU - Kelly, Daniel P.

AU - Arany, Zoltan

AU - Poole, David C.

AU - Wagner, Peter D.

AU - Chirinos, Julio A.

PY - 2020/3

Y1 - 2020/3

N2 - The aim of this study was to determine the arteriovenous oxygen content difference (ΔAVO2) in adult subjects with and without heart failure with preserved ejection fraction (HFpEF) during systemic and forearm exercise. Subjects with HFpEF had reduced ΔAVO2. Forearm diffusional conductance for oxygen, a lumped conductance parameter that incorporates all impediments to the movement of oxygen from red blood cells in skeletal muscle capillaries into the mitochondria within myocytes, was estimated. Forearm diffusional conductance for oxygen was not different among adults with HFpEF, those with hypertension, and healthy control subjects; therefore, diffusional conductance cannot explain the reduced forearm ΔAVO2. Instead, adiposity was strongly associated with ΔAVO2, suggesting an active role for adipose tissue in reducing exercise capacity in patients with HFpEF.

AB - The aim of this study was to determine the arteriovenous oxygen content difference (ΔAVO2) in adult subjects with and without heart failure with preserved ejection fraction (HFpEF) during systemic and forearm exercise. Subjects with HFpEF had reduced ΔAVO2. Forearm diffusional conductance for oxygen, a lumped conductance parameter that incorporates all impediments to the movement of oxygen from red blood cells in skeletal muscle capillaries into the mitochondria within myocytes, was estimated. Forearm diffusional conductance for oxygen was not different among adults with HFpEF, those with hypertension, and healthy control subjects; therefore, diffusional conductance cannot explain the reduced forearm ΔAVO2. Instead, adiposity was strongly associated with ΔAVO2, suggesting an active role for adipose tissue in reducing exercise capacity in patients with HFpEF.

KW - adiposity

KW - aerobic capacity

KW - exercise

KW - HFpEF

KW - oxygen transport

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Peripheral Determinants of Oxygen Utilization in Heart Failure With Preserved Ejection Fraction: Central Role of Adiposity

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