Scientific Reports (Sep 2024)

Differential impacts of body composition on oxygen kinetics and exercise tolerance of HFrEF and HFpEF patients

  • Gerson Cipriano,
  • Cássia da Luz Goulart,
  • Gaspar R. Chiappa,
  • Marianne Lucena da Silva,
  • Natália Turri Silva,
  • Amanda Oliveira do Vale Lira,
  • Edson Marcio Negrão,
  • Luciana Bartolomei Orru DÁvila,
  • Sergio Henrique Rodolpho Ramalho,
  • Fausto Stauffer Junqueira de Souza,
  • Graziella França Bernardelli Cipriano,
  • Daniel Hirai,
  • Dominique Hansen,
  • Lawrence Patrick Cahalin

DOI
https://doi.org/10.1038/s41598-024-72965-0
Journal volume & issue
Vol. 14, no. 1
pp. 1 – 12

Abstract

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Abstract This study aims to (1) compare the kinetics of pulmonary oxygen uptake (VO2p), skeletal muscle deoxygenation ([HHb]), and microvascular O2 delivery (QO2mv) between heart failure (HF) patients with reduced ejection fraction (HFrEF) and those with preserved ejection fraction (HFpEF), and (2) explore the correlation between body composition, kinetic parameters, and exercise performance. Twenty-one patients (10 HFpEF and 11 HFrEF) underwent cardiopulmonary exercise testing to assess VO2 kinetics, with near-infrared spectroscopy (NIRS) employed to measure [HHb]. Microvascular O2 delivery (QO2mv) was calculated using the Fick principle. Dual-energy X-ray absorptiometry (DEXA) was performed to evaluate body composition. HFrEF patients exhibited significantly slower VO2 kinetics (time constant [t]: 63 ± 10.8 s vs. 45.4 ± 7.9 s; P < 0.05) and quicker [HHb] response (t: 12.4 ± 9.9 s vs. 25 ± 11.6 s; P < 0.05). Microvascular O2 delivery (QO2mv) was higher in HFrEF patients (3.6 ± 1.2 vs. 1.7 ± 0.8; P < 0.05), who also experienced shorter time to exercise intolerance (281.6 ± 84 s vs. 405.3 ± 96 s; P < 0.05). Correlation analyses revealed a significant negative relationship between time to exercise and both QO2mv (ρ= -0.51; P < 0.05) and VO2 kinetics (ρ= -0.63). Body adiposity was negatively correlated with [HHb] amplitude (ρ= -0.78) and peak VO2 (ρ= -0.54), while a positive correlation was observed between lean muscle percentage, [HHb] amplitude, and tau (ρ= 0.74 and 0.57; P < 0.05), respectively. HFrEF patients demonstrate more severely impaired VO2p kinetics, skeletal muscle deoxygenation, and microvascular O2 delivery compared to HFpEF patients, indicating compromised peripheral function. Additionally, increased adiposity and reduced lean mass are linked to decreased oxygen diffusion capacity and impaired oxygen uptake kinetics in HFrEF patients.

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