| Autor: |
Curtis A. Wadey, Alan R. Barker, A. Graham Stuart, Dan‐Mihai Dorobantu, Guido E. Pieles, Derek L. Tran, Karina Laohachai, Julian Ayer, Rob G. Weintraub, Rachael Cordina, Craig A. Williams |
| Jazyk: |
angličtina |
| Rok vydání: |
2024 |
| Předmět: |
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| Zdroj: |
Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, Vol 13, Iss 24 (2024) |
| Druh dokumentu: |
article |
| ISSN: |
2047-9980 |
| DOI: |
10.1161/JAHA.123.034944 |
| Popis: |
Background Peak oxygen consumption (peak V̇$$ \dot{\mathrm{V}} $$O2) is traditionally scaled by body mass, but it is most appropriately scaled by fat‐free mass. However, it is unknown whether peak V̇$$ \dot{\mathrm{V}} $$O2 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 V̇$$ \dot{\mathrm{V}} $$O2 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 V̇$$ \dot{\mathrm{V}} $$O2 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 V̇$$ \dot{\mathrm{V}} $$O2. In univariable models, peak V̇$$ \dot{\mathrm{V}} $$O2 ratio scaled to body mass was not significantly associated with FF (HR, 0.91; P=0.111). However, peak V̇$$ \dot{\mathrm{V}} $$O2 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 V̇$$ \dot{\mathrm{V}} $$O2 and FF is improved when scaled to measures of body composition. Applied clinically, a 1‐unit increase in peak V̇$$ \dot{\mathrm{V}} $$O2 scaled to fat‐free mass or lean mass is associated with a ≈10% lower risk of FF. |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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