Peripheral Determinants of Oxygen Utilization in Heart Failure With Preserved Ejection Fraction

Autor: Elizabeth A. Proto, David C. Poole, Stuart B. Prenner, Kenneth B. Margulies, Peter D. Wagner, Daniel P. Kelly, Payman Zamani, Julio A. Chirinos, Raymond R. Townsend, Jeremy A. Mazurek, Zoltan Arany
Jazyk: angličtina
Rok vydání: 2020
Předmět:
0301 basic medicine
medicine.medical_specialty
CLINICAL RESEARCH
CO
cardiac output
Apparent oxygen utilisation
Po2
partial pressure of oxygen
Adipose tissue
HFpEF
heart failure with preserved ejection fraction
B100
Vo2
oxygen consumption
030204 cardiovascular system & hematology
03 medical and health sciences
0302 clinical medicine
Forearm
Internal medicine
medicine
Myocyte
adiposity
exercise
business.industry
DEXA
dual-energy x-ray absorptiometry
ΔAVo2
arteriovenous oxygen content difference
FIo2
fraction of inspired oxygen
Oxygen transport
Skeletal muscle
HFpEF
C600
Peripheral
aerobic capacity
NT-proBNP
N-terminal pro–brain natriuretic peptide
body regions
DmO2
skeletal muscle diffusional conductance for oxygen
030104 developmental biology
medicine.anatomical_structure
oxygen transport
Cardiology
MVC
maximal voluntary contraction force
Cardiology and Cardiovascular Medicine
business
Heart failure with preserved ejection fraction
Zdroj: JACC: Basic to Translational Science
ISSN: 2452-302X
Popis: Visual Abstract
Highlights • ΔAVo2 during exercise is a complex metric that incorporates into its calculation skeletal muscle blood flow and DmO2 across the skeletal muscle capillary membrane. • Although ΔAVo2 was reduced in patients with HFpEF during both systemic and local (forearm) exercise, there was no difference in forearm DmO2 among subjects with HFpEF, those with hypertension, and healthy control subjects; therefore, abnormalities in forearm DmO2 cannot explain the reduced forearm ΔAVo2 seen in subjects with HFpEF. • Local forearm exercise performance predicted about one-third of the variability in systemic aerobic capacity, demonstrating that peripheral factors are important in determining whole-body exercise tolerance. • Degree of adiposity strongly correlated with ΔAVo2 during both local and whole-body exercise, suggesting that adipose tissue may play an active role in limiting exercise capacity in subjects with HFpEF.
Summary 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.
Databáze: OpenAIRE
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