Peak Oxygen Consumption Scaled to Body Composition Is Associated With Mortality and Morbidity in People With a Fontan Circulation.

Autor: Wadey CA; Children's Health & Exercise Research Centre (CHERC) Public Health and Sports Sciences, Faculty of Health and Life Sciences, University of Exeter Exeter United Kingdom.; Research and Improvement Hampshire and Isle of Wight Healthcare NHS Foundation Trust Hampshire United Kingdom., Barker AR; Children's Health & Exercise Research Centre (CHERC) Public Health and Sports Sciences, Faculty of Health and Life Sciences, University of Exeter Exeter United Kingdom., Stuart AG; Bristol Congenital Heart Centre The Bristol Heart Institute, University Hospitals Bristol NHS Foundation Trust Bristol United Kingdom., Dorobantu DM; Children's Health & Exercise Research Centre (CHERC) Public Health and Sports Sciences, Faculty of Health and Life Sciences, University of Exeter Exeter United Kingdom.; Bristol Congenital Heart Centre The Bristol Heart Institute, University Hospitals Bristol NHS Foundation Trust Bristol United Kingdom., Pieles GE; Bristol Congenital Heart Centre The Bristol Heart Institute, University Hospitals Bristol NHS Foundation Trust Bristol United Kingdom.; Sports Cardiology and Screening Department ASPETAR Qatar Orthopaedic and Sports Medicine Hospital Doha Qatar., Tran DL; Central Clinical School, The University of Sydney Camperdown New South Wales Australia.; Department of Cardiology Royal Prince Alfred Hospital Camperdown New South Wales Australia.; Heart Research Institute, Charles Perkins Centre, The University of Sydney Camperdown New South Wales Australia., Laohachai K; Central Clinical School, The University of Sydney Camperdown New South Wales Australia.; Department of Cardiology Royal Prince Alfred Hospital Camperdown New South Wales Australia.; Heart Research Institute, Charles Perkins Centre, The University of Sydney Camperdown New South Wales Australia., Ayer J; Central Clinical School, The University of Sydney Camperdown New South Wales Australia.; Department of Cardiology Royal Prince Alfred Hospital Camperdown New South Wales Australia.; Heart Research Institute, Charles Perkins Centre, The University of Sydney Camperdown New South Wales Australia., Weintraub RG; Department of Cardiology Royal Children's Hospital Melbourne Victoria Australia.; Department of Paediatrics Melbourne University Melbourne Victoria Australia., Cordina R; Central Clinical School, The University of Sydney Camperdown New South Wales Australia.; Department of Cardiology Royal Prince Alfred Hospital Camperdown New South Wales Australia.; Heart Research Institute, Charles Perkins Centre, The University of Sydney Camperdown New South Wales Australia., Williams CA; Children's Health & Exercise Research Centre (CHERC) Public Health and Sports Sciences, Faculty of Health and Life Sciences, University of Exeter Exeter United Kingdom.
Jazyk: angličtina
Zdroj: Journal of the American Heart Association [J Am Heart Assoc] 2024 Dec 17; Vol. 13 (24), pp. e034944. Date of Electronic Publication: 2024 Dec 14.
DOI: 10.1161/JAHA.123.034944
Abstrakt: Background: Peak oxygen consumption (peak V ̇ $$ \dot{\mathrm{V}} $$ O 2 ) is traditionally scaled by body mass, but it is most appropriately scaled by fat-free mass. However, it is unknown whether peak V ̇ $$ \dot{\mathrm{V}} $$ O 2 scaled by fat-free mass is associated with mortality and morbidity in people with a Fontan circulation. The aim of this study was to assess the associations between different expressions of peak V ̇ $$ \dot{\mathrm{V}} $$ O 2 with mortality and morbidity in people with a Fontan circulation.
Methods and Results: Eighty-seven participants (aged 24.1±7.3 years; 53% women) with a Fontan circulation completed a cardiopulmonary exercise test and a dual-energy x-ray absorptiometry scan. Cox proportional hazard regressions models assessed the association (hazard ratio [HR]) between different expressions of peak V ̇ $$ \dot{\mathrm{V}} $$ O 2 with a composite outcome of Fontan failure (FF). Participants were followed up for a median of 6.5 years (95% CI, 6.4-6.9). Individuals experiencing FF (n=10/87) had a significantly lower absolute peak V ̇ $$ \dot{\mathrm{V}} $$ O 2 . In univariable models, peak V ̇ $$ \dot{\mathrm{V}} $$ O 2 ratio scaled to body mass was not significantly associated with FF (HR, 0.91; P =0.111). However, peak V ̇ $$ \dot{\mathrm{V}} $$ O 2 scaled by fat-free mass (HR, 0.90; P =0.020) or lean mass (HR, 0.90; P =0.017) was significantly and inversely associated with FF. These associations remained significant after adjusting for age, sex, and peak respiratory exchange ratio.
Conclusions: The association between peak V ̇ $$ \dot{\mathrm{V}} $$ O 2 and FF is improved when scaled to measures of body composition. Applied clinically, a 1-unit increase in peak V ̇ $$ \dot{\mathrm{V}} $$ O 2 scaled to fat-free mass or lean mass is associated with a ≈10% lower risk of FF.
Databáze: MEDLINE
Externí odkaz: