Baseline and Exercise Predictors of VO2peak in Systolic Heart Failure Patients: Results from SMARTEX-HF

Trine Karlsen, Vibeke Videm, Martin Halle, Øyvind Ellingsen, Asbjørn Støylen, Håvard Dalen, Charles Delagardelle, Alf-Inge Larsen, Torstein Hole, Alessandro Mezzani, Emeline M Van Craenenbroeck, Paul Beckers, Axel Pressler, Jeffrey W Christle, Ephraim Winzer, Norman Mangner, Felix Woitek, Robert Höllriegel, Martin Snoer, Patrick FeiereisenTorstein Valborgland, Axel Linke, Eva Prescott


PURPOSE: To investigate baseline, exercise testing, and exercise training-mediated predictors of change in peak oxygen uptake (VO2peak) from baseline to 12-week follow-up (ΔVO2peak) in a post-hoc analysis from the SMARTEX Heart Failure trial.

METHODS: We studied 215 patients with heart failure with left ventricular ejection fraction (LVEF) <35%, and NYHA class II-III, who were randomized to either supervised high intensity interval training (HIIT) with exercise target intensity 90-95% of peak heart rate (HRpeak), supervised moderate continuous training (MCT) with target intensity 60-70% of HRpeak, or who received a recommendation of regular exercise on their own (RRE). Predictors of ΔVO2peak were assessed in two models; A logistic regression model comparing highest and lowest tertile (baseline parameters) and a multivariate linear regression model (test/training/clinical parameters).

RESULTS: The change in VO2peak in response to the interventions (ΔVO2peak) varied substantially, from -8.50 to +11.30 mL·kg·min. Baseline NYHA (class II gave higher odds vs III, odds ratio (OR) 7.1 (2.0, 24.9), p=0.002), LVEF OR per % 1.1 (1.0, 1.2), p = 0.005), age (OR per 10 years 0.5 (0.3, 0.8)), p=0.003) were associated with ΔVO2peak.In the multivariate linear regression, 34% of the variability in [INCREMENT]VO2peak was explained by the increase in exercise training workload, [INCREMENT]HRpeak between baseline and 12-wk post-testing, age, and ever having smoked.

CONCLUSION: Exercise training response (ΔVO2peak) correlated negatively with age, LVEF and NYHA class. The ability to increase workload during the training period, and increased ΔHRpeak between baseline and the 12-week test were associated with a positive outcome.

TidsskriftMedicine and Science in Sports and Exercise
StatusE-pub ahead of print - 1 nov. 2019


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