Renal function and peak exercise oxygen consumption in chronic heart failure with reduced left ventricular ejection fraction

Domenico Scrutinio, Piergiuseppe Agostoni, Loreto Gesualdo, Ugo Corra, Alessandro Mezzani, Massimo Piepoli, Andrea Di Lenarda, Annamaria Iorio, Claudio Passino, Damiano Magri, Daniele Masarone, Elisa Battaia, Davide Girola, Federica Re, Gaia Cattadori, Gianfranco Parati, Gianfranco Sinagra, Giovanni Quinto Villani, Giuseppe Limongelli, Giuseppe PacileoMarco Guazzi, Marco Metra, Maria Frigerio, Mariantonietta Cicoira, Chiara Miná, Gabriella Malfatto, Sergio Caravita, Maurizio Bussotti, Elisabetta Salvioni, Fabrizio Veglia, Michele Correale, Angela B. Scardovi, Michele Emdin, Pantaleo Giannuzzi, Paola Gargiulo, Marta Giovannardi, Pasquale Perrone-Filardi, Rosa Raimondo, Roberto Ricci, Stefania Paolillo, Stefania Farina, Romualdo Belardinelli, Andrea Passantino, Rocco La Gioia, Cesare Fiorentini, Anna Apostolo, Pietro Palermo, Mauro Contini, Erika Bertella, Valentina Mantegazza, Francesca Pietrucci, Aessandro Ferraironi, Matteo Casenghi, Francesco Clemenza, Teo Roselli, Andrea Buono, Raffaele Calabrò, Daniela Santoro, Saba Campanale, Domenica Caputo, Donatella Bertipaglia, Raffaella Vaninetti, Marco Confalonieri, Elena Zambon, Emanuela Berton, Chiara Torregiani, Livio Dei Cas, Valentina Carubelli, Simone Binno, Giovanni Marchese, Fabrizio Oliva, Luigi Pastormerlo

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Chronic kidney disease is associated with sympathetic activation and muscle abnormalities, which may contribute to decreased exercise capacity. We investigated the correlation of renal function with peak exercise oxygen consumption (V˙O2) in heart failure (HF) patients. Methods and Results: We recruited 2,938 systolic HF patients who underwent clinical, laboratory, echocardiographic and cardiopulmonary exercise testing. The patients were stratified according to estimated glomerular filtration rate (eGFR). Mean follow-up was 3.7 years. The primary outcome was a composite of cardiovascular death and urgent heart transplantation at 3 years. On multivariable regression, eGFR was predictor of peakV˙O2 (P−1 ・ min−1 was 1.75 (95% confidence interval (CI): 1.06–2.91; P=0.0292) in patients with eGFR ≥60, 1.77 (0.87–3.61; P=0.1141) in those with eGFR of 45–59, and 2.72 (1.01– 7.37; P=0.0489) in those with eGFR − 1 ・ 1.73 m 2. The area under the receiver-operating characteristic curve for peakV˙O21 ・ min 1 was 0.63 (95% CI: 0.54–0.71), 0.67 (0.56–0.78), and 0.57 (0.47–0.69), respectively. Testing for interaction was not significant. Conclusions: Renal dysfunction is correlated with peakV O2. A peakV O2 cutoff of 12 ml ・ kg–1 ・ min–1 offers limited prognostic information in HF patients with more severely impaired renal function.

Original languageEnglish
Pages (from-to)583-591
Number of pages9
JournalCirculation Journal
Volume79
Issue number3
DOIs
Publication statusPublished - 2015

Keywords

  • Heart failure
  • Peak exercise oxygen consumption
  • Prognosis
  • Renal function

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Medicine(all)

Fingerprint

Dive into the research topics of 'Renal function and peak exercise oxygen consumption in chronic heart failure with reduced left ventricular ejection fraction'. Together they form a unique fingerprint.

Cite this