Heart failure & cardiomyopathies
Skeletal Muscle Quantity Versus Quality in Heart Failure: Exercise Intolerance and Outcomes in Older Patients With Heart Failure with Preserved Ejection Fraction (HFpEF) Are Related to Abnormal Skeletal Muscle Metabolism Rather Than Age-Related Skeletal Muscle Loss
Authors' conclusion
EI in older patients with HFpEF is closely linked to age-associated abnormalities in SM energy metabolism, namely, rapid exercise-induced energetic decline and worse energetic profile at fatigue, and not SM quantity. Abnormal SM energy metabolism is associated with worse outcomes in patients with HFpEF in unadjusted analysis. These findings support SM energy metabolism as a barometer of systemic HFpEF severity and the pursuit of new SM metabolic modulators to reduce disabling EI and possibly adverse outcomes in patients with HFpEF.
Study context
- Population
- Patients with HFpEF (aged 34–86 years) with left ventricular ejection fraction ≥50%, stratified by age
- Participants
- 64 patients
- Exposure
- Older vs younger patients with HFpEF; Skeletal muscle (SM) quantity versus metabolic quality in relation to exercise intolerance (EI) and outcomes
- Outcome
- EI, calf muscle, exercise-induced high-energy phosphate decline, SM energetics at fatigue
Main finding
As reported in the abstract
- Older patients with HFpEF exhibited more severe EI, less calf muscle, faster exercise-induced high-energy phosphate decline, and worse SM energetics at fatigue than younger patients
Observational data: associations, not effects.
Further findings
EI vs muscle quality and quantity
- EI correlated closely with muscle metabolic quality, not quantity
- Neither magnetic resonance imaging exercise time, 6-minute walk distance, nor peak oxygen uptake correlated with calf SM area
- 6-minute walk distance or peak oxygen uptake inversely related to rapid exercise-induced high-energy phosphate decline and worse SM energetic profile at fatigue
Cardiovascular death or heart failure hospitalizations · median of 39.3 months
- Rapid exercise-induced high-energy phosphate decline and lower ATP at fatigue associated with increased cardiovascular death or heart failure hospitalizations
- Univariate analysis
Original publication
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