Worsening Depressive Symptoms Are Associated With Adverse Clinical Outcomes in Patients With Heart Failure

To assess the impact of changes in symptoms of depression over a 1-year time period on subsequent clinical outcomes in heart failure (HF) patients

A sex-specific relationship between capillary density and anaerobic threshold

Although both capillary density and peak oxygen consumption (V̇o2) improve with exercise training, it is difficult to find a relationship between these two measures. It has been suggested that peak V̇o2 may be more related to central hemodynamics than to the oxidative potential of skeletal muscle, which may account for this observation. We hypothesized that change in a measure of submaximal performance, anaerobic threshold, might be related to change in skeletal muscle capillary density, a marker of oxidative potential in muscle, with training. Due to baseline differences among these variables, we also hypothesized that relationships might be sex specific. A group of 21 subjects completed an inactive control period, whereas 28 subjects (17 men and 11 women) participated in a 6-mo high-intensity exercise program. All subjects were sedentary, overweight, and dyslipidemic. Potential relationships were assessed between change in capillary density with both change in V̇o2 at peak and at anaerobic threshold with exercise training. All variables and relationships were assessed for sex-specific effects. Change in peak V̇o2 was not related to change in capillary density after exercise training in either sex. Men had a positive correlation between change in V̇o2 at anaerobic threshold and change in capillary density with exercise training (r = 0.635; P < 0.01), whereas women had an inverse relationship (r = −0.636; P < 0.05) between the change in these variables. These findings suggest that, although enhanced capillary density is associated with training-induced improvements in submaximal performance in men, this relationship is different in women

A sex-specific relationship between capillary density and anaerobic threshold

Although both capillary density and peak oxygen consumption (VO2) improve with exercise training it is difficult to find a relationship between these two measures. It has been suggested that peak VO2 may be more related to central hemodynamics than to the oxidative potential of skeletal muscle which may account for this observation. We hypothesized that change in a measure of submaximal performance anaerobic threshold might be related to change in skeletal muscle capillary density a marker of oxidative potential in muscle with training. Due to baseline differences among these variables we also hypothesized that relationships might be sex specific. A group of 21 subjects completed an inactive control period whereas 28 subjects (17 men and 11 women) participated in a 6-mo high-intensity exercise program. All subjects were sedentary overweight and dyslipidemic. Potential relationships were assessed between change in capillary density with both change in VO2 at peak and at anaerobic threshold with exercise training. All variables and relationships were assessed for sex-specific effects. Change in peak VO2 was not related to change in capillary density after exercise training in either sex. Men had a positive correlation between change in VO2 at anaerobic threshold and change in capillary density with exercise training (r 0.635; P 0.01) whereas women had an inverse relationship (r 0.636; P 0.05) between the change in these variables. These findings suggest that although enhanced capillary density is associated with training- induced improvements in submaximal performance in men this relationship is different in women. Originally published Journal of Applied Physiology Vol. 106 No. 4 Apr 200

A meta-analysis of the prognostic significance of cardiopulmonary exercise testing in patients with heart failure

The objective of the study is to assess the role of cardiopulmonary exercise testing (CPX) variables, including peak oxygen consumption (VO ), which is the most recognized CPX variable, the minute ventilation/carbon dioxide production (VE/VCO) slope, the oxygen uptake efficiency slope (OUES), and exercise oscillatory ventilation (EOV) in a current meta-analysis investigating the prognostic value of a broader list of CPX-derived variables for major adverse cardiovascular events in patients with HF. A search for relevant CPX articles was performed using standard meta-analysis methods. Of the initial 890 articles found, 30 met our inclusion criteria and were included in the final analysis. The total subject populations included were as follows: peak VO (7,319), VE/VCO slope (5,044), EOV (1,617), and OUES (584). Peak VO, the VE/VCO slope and EOV were all highly significant prognostic markers (diagnostic odds ratios ≥ 4.10). The OUES also demonstrated promise as a prognostic marker (diagnostic odds ratio = 8.08) but only in a limited number of studies (n = 2). No other independent variables (including age, ejection fraction, and beta-blockade) had a significant effect on the meta-analysis results for peak VO and the VE/VCO slope. CPX is an important component in the prognostic assessment of patients with HF. The results of this meta-analysis strongly confirm this and support a multivariate approach to the application of CPX in this patient population