Impact of whole-body and skeletal muscle composition on peak oxygen uptake in heart failure: a systematic review and meta-analysis.

European heart journal open Pub Date : 2024-09-26 eCollection Date: 2024-09-01 DOI:10.1093/ehjopen/oeae082
Veronika Schmid, Stephen J Foulkes, Devyn Walesiak, Jing Wang, Corey R Tomczak, Wesley J Tucker, Siddhartha S Angadi, Martin Halle, Mark J Haykowsky
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Abstract

Aims: Heart failure (HF) has a major impact on exercise tolerance that may (in part) be due to abnormalities in body and skeletal muscle composition. This systematic review and meta-analysis aims to assess how differences in whole-body and skeletal muscle composition between patients with HF and non-HF controls (CON) contribute to reduced peak oxygen uptake (VO2peak).

Methods and results: The PubMed database was searched from 1975 to May 2024 for eligible studies. Cross-sectional studies with measures of VO2peak, body composition, or muscle biopsies in HF and CON were considered. Out of 709 articles, 27 studies were included in this analysis. Compared with CON, VO2peak [weighted mean difference (WMD): -9.96 mL/kg/min, 95% confidence interval (CI): -11.71 to -8.21), total body lean mass (WMD: -1.63 kg, 95% CI: -3.05 to -0.21), leg lean mass (WMD: -1.38 kg, 95% CI: -2.18 to -0.59), thigh skeletal muscle area (WMD: -10.88 cm2 , 95% CI: -21.40 to -0.37), Type I fibres (WMD: -7.76%, 95% CI: -14.81 to -0.71), and capillary-to-fibre ratio (WMD: -0.27, 95% CI: -0.50 to -0.03) were significantly lower in HF. Total body fat mass (WMD: 3.34 kg, 95% CI: 0.35-6.34), leg fat mass (WMD: 1.37 kg, 95% CI: 0.37-2.37), and Type IIx fibres (WMD: 7.72%, 95% CI: 1.52-13.91) were significantly higher in HF compared with CON. Absolute VO2peak was significantly associated with total body and leg lean mass, thigh skeletal muscle area, and capillary-to-fibre ratio.

Conclusion: Individuals with HF display abnormalities in body and skeletal muscle composition including reduced lean mass, oxidative Type I fibres, and capillary-to-fibre ratio that negatively impact VO2peak.

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全身和骨骼肌成分对心力衰竭患者峰值摄氧量的影响:系统回顾和荟萃分析。
目的:心力衰竭(HF)对运动耐量有很大影响,这可能(部分)是由于身体和骨骼肌成分异常造成的。本系统综述和荟萃分析旨在评估心力衰竭患者和非心力衰竭对照组(CON)之间全身和骨骼肌组成的差异如何导致峰值摄氧量(VO2peak)降低:在PubMed数据库中搜索了1975年至2024年5月期间符合条件的研究。研究考虑了对高频和低频患者的VO2peak、身体成分或肌肉活检进行测量的横断面研究。在 709 篇文章中,有 27 项研究被纳入本次分析。与 CON 相比,VO2peak(加权平均差(WMD):-9.96 mL/kg/min,95% 置信区间(CI):-11.71 至 -8.21)、全身瘦体重(WMD:-1.63 kg,95% CI:-3.05 至 -0.21)、腿部瘦体重(WMD:-1.38 kg,95% CI:-2.18至-0.59)、大腿骨骼肌面积(WMD:-10.88平方厘米,95% CI:-21.40至-0.37)、I型纤维(WMD:-7.76%,95% CI:-14.81至-0.71)和毛细血管与纤维比率(WMD:-0.27,95% CI:-0.50至-0.03)均显著低于高血脂患者。与 CON 相比,HF 患者的全身脂肪量(WMD:3.34 千克,95% CI:0.35-6.34)、腿部脂肪量(WMD:1.37 千克,95% CI:0.37-2.37)和 IIx 型纤维(WMD:7.72%,95% CI:1.52-13.91)明显较高。绝对 VO2 峰值与全身和腿部瘦体重、大腿骨骼肌面积以及毛细血管与纤维比率有明显相关性:结论:心房颤动患者的身体和骨骼肌组成存在异常,包括瘦体重、氧化性 I 型纤维和毛细血管与纤维比率减少,这对 VO2 峰产生了负面影响。
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