Low skeletal muscle mass is associated with low aerobic capacity and increased mortality risk in patients with coronary heart disease – a CARE CR study

Nichols, Simon; O’Doherty, Alasdair F.; Taylor, Claire; Clark, Andrew L.; Carroll, Sean; Ingle, Lee

doi:10.1111/cpf.12539

Cited by 42 publications

(55 citation statements)

References 44 publications

(80 reference statements)

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“…In contrast, exercise rehabilitation may reduce sympathetic activity and improve HF outcomes by its effect on muscle function. It has been demonstrated that low skeletal muscle mass is associated with low aerobic capacity and increased mortality risk in HF patients (CARE-CR study) [63].…”

Section: Sarcopenia Ergoreflex and Hfmentioning

confidence: 99%

Sarcopenia and Heart Failure

et al. 2020

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Modifications of lean mass are a frequent critical determinant in the pathophysiology and progression of heart failure (HF). Sarcopenia may be considered one of the most important causes of low physical performance and reduced cardiorespiratory fitness in older patients with HF. Sarcopenia is frequently misdiagnosed as cachexia. However, muscle wasting in HF has different pathogenetic features in sarcopenic and cachectic conditions. HF may induce sarcopenia through common pathogenetic pathways such as hormonal changes, malnutrition, and physical inactivity; mechanisms that influence each other. In the opposite way, sarcopenia may favor HF development by different mechanisms, including pathological ergoreflex. Paradoxically, sarcopenia is not associated with a sarcopenic cardiac muscle, but the cardiac muscle shows a hypertrophy which seems to be “not-functional.” First-line agents for the treatment of HF, physical activity and nutritional interventions, may offer a therapeutic advantage in sarcopenic patients irrespective of HF. Thus, sarcopenia is highly prevalent in patients with HF, contributing to its poor prognosis, and both conditions could benefit from common treatment strategies based on pharmacological, physical activity, and nutritional approaches.

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Section: Sarcopenia Ergoreflex and Hfmentioning

confidence: 99%

Sarcopenia and Heart Failure

et al. 2020

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“…Similarly, exercise may induce left ventricular dysfunction which can also limit peak stroke volume and therefore, Q [55]. These factors may impede the delivery of oxygenated blood to the exercising muscle [56,57] where adverse changes to skeletal muscle physiology including low muscle mass [58,59], poor perfusion and matching of the capillaries and muscle fibres, as well as reduced muscle oxidative capacity [56], may reduce a-vO 2 diff and aerobic synthesis of adenosine triphosphate [55]. A low Q and a-vO 2 diff causes a marked reduction in VO 2peak such that the VO 2peak of men (20.2 ml • kg − 1 • min − 1 ) [51] and women (15.1 ml • kg − 1 • min − ) [52] with heart disease who are aged between 50 and 59 years is typically half of that found in healthy men (42.1 ml • kg − 1 • min − 1 ) and women (33.7 ml • kg − 1 • min − 1 ) of a similar age [60].…”

Section: The Role Of Aerobic Fitnessmentioning

confidence: 99%

Current Insights into Exercise-based Cardiac Rehabilitation in Patients with Coronary Heart Disease and Chronic Heart Failure

et al. 2020

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AbstractCardiac rehabilitation is a package of lifestyle secondary prevention strategies designed for patients with coronary heart disease and chronic heart failure. A community-based cardiac rehabilitation programme provides patients with a structured exercise training intervention alongside educational support and psychological counselling. This review provides an update regarding the clinical benefits of community-based cardiac rehabilitation from a psycho-physiological perspective, and also focuses on the latest epidemiological evidence regarding potential survival benefits. Behaviour change is key to long-term adoption of a healthy and active lifestyle following a cardiac event. In order for lifestyle interventions such as structured exercise interventions to be adopted by patients, practitioners need to ensure that behaviour change programmes are mapped against patient’s priorities and values, and adapted to their level of readiness and intention to engage with the target behaviour. We review the evidence regarding behaviour change strategies for cardiac patients and provide practitioners with the latest guidance. The ‘dose’ of exercise training delivered to patients attending exercise-based cardiac rehabilitation is an important consideration because an improvement in peak oxygen uptake requires an adequate physiological stimulus to invoke positive physiological adaptation. We conclude by critically reviewing the latest evidence regarding exercise dose for cardiac patients including the role of traditional and more contemporary training interventions including high intensity interval training.

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“…In fact, physical fitness is considered one of the most important health markers and commonly understood as a predictor of morbidity and mortality for cardiovascular diseases [ 14 , 15 ]. As such, numerous studies have shown that a high BMI and/or obesity are associated with poor physical fitness due to the higher body fat and lower skeletal muscle mass [ 16 – 19 ]. Moreover, both skeletal muscle mass and strength might be closely associated with cardiorespiratory fitness [ 20 , 21 ] and health [ 22 ], providing reasoning to assume that skeletal muscle may mediate the relationship between NWO and physical fitness.…”

Section: Introductionmentioning

confidence: 99%

Normal weight obesity and physical fitness in Chinese university students: an overlooked association

et al. 2018

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BackgroundThe primary aim of this study was to examine the associations of normal weight obesity (NWO) with physical fitness in Chinese university students. As a secondary aim, we assessed whether possible differences in physical fitness between students classified as NWO and normal weight non-obese (NWNO) were mediated by skeletal muscles mass.MethodsA total of 383 students (205 males and 178 females, aged 18–24 years) from two universities volunteered to participate in this study. Body height and weight were measured by standard procedures and body composition was assessed by bio-impedance analysis (InBody 720). NWO was defined by a BMI of 18.5–23.9 kg/m2 and a body fat percentage of > 20% or > 30% in male and female students, respectively. Physical fitness was measured using a 10-min intermittent endurance running test (Andersen test), countermovement jumps (CMJ) and a 5 × 5 m shuttle run test (5mSR). The level of leisure time physical activity (PA) was assessed by a questionnaire.Results13.7% of male and 27.5% of female students were classified as NWO. Compared to NWNO, students classified as NWO showed a significantly poorer performance in the Andersen test (males: 1146 ± 70 m vs. 1046 ± 95 m, females: 968 ± 61 m vs. 907 ± 67 m, p < 0.001), CMJ (males: 55.0 ± 7.6 cm vs. 44.9 ± 7.5 cm, females: 39.8 ± 8.0 cm vs. 33.7 ± 5.9 cm, p < 0.001) and 5mSR (males: 18.7 ± 1.0 s vs. 20.0 ± 0.9 s, females: 21.1 ± 1.1 s vs. 22.4 ± 1.3 s, p < 0.001), respectively. The lower levels of physical fitness in NWO were partially explained by lower skeletal muscle mass (p < 0.001) both in male and female students.ConclusionsNWO was associated with poorer physical fitness and the relationship was partially mediated by lower skeletal muscle mass. The study indicated that attention should be paid for the potential hidden health risk in university students with normal body mass index but excessive fat mass.Electronic supplementary materialThe online version of this article (10.1186/s12889-018-6238-3) contains supplementary material, which is available to authorized users.

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Low skeletal muscle mass is associated with low aerobic capacity and increased mortality risk in patients with coronary heart disease – a CARE CR study

Cited by 42 publications

References 44 publications

Sarcopenia and Heart Failure

Sarcopenia and Heart Failure

Current Insights into Exercise-based Cardiac Rehabilitation in Patients with Coronary Heart Disease and Chronic Heart Failure

Normal weight obesity and physical fitness in Chinese university students: an overlooked association

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