TY - JOUR
T1 - Comparison of cardiorespiratory fitness in black or african American versus caucasian patients with heart failure
AU - Canada, Justin M.
AU - Park, Tae Shik
AU - Ravindra, Krishna
AU - Chiabrando, Juan G.
AU - Del Buono, Marco Giuseppe
AU - van Wezenbeek, Jessie
AU - Trankle, Cory R.
AU - Kadariya, Dinesh
AU - Keen, Larry
AU - Carbone, Salvatore
AU - Billingsley, Hayley
AU - Wohlford, George F.
AU - Arena, Ross
AU - van Tassell, Benjamin W.
AU - Abbate, Antonio
N1 - Publisher Copyright: © 2021 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2021
Y1 - 2021
N2 - Purpose: Cardiopulmonary exercise testing (CPX) is a well-established assessment with important insight into prognosis and therapeutic efficacy in patients with heart failure (HF). Prior studies have identified several clinical differences between Black or African American (B-AA) and Caucasian patients with HF. Differences in key CPX responses between these two groups require further investigation. Methods: Using a database consisting of subjects with symptomatic HF who had undergone CPX for inclusion in various prospective randomized clinical trials, we identified 198 (n = 94 [47%] B-AA; n = 105 [53%] Caucasian) patients with a qualifying baseline CPX. Significant univariate predictors of peak oxygen uptake (Vo2peak) were included in a multivariate linear regression model. Results: When compared with Caucasian patients, B-AA were younger (mean ± SD = 54.8 ± 10.0 vs 57.9 ± 9.6 yr, P =.03), had higher C-reactive protein (CRP) (median [IQR] = 4.9 [2.3, 8.8] vs 1.9 [0.6, 5.5] mg/L, P <.0001), lower hemoglobin (13.0 ± 1.8 vs 13.8 ± 1.6 g/dL, P =.003), and lower left ventricular ejection fraction (LVEF) (40 [32, 51] vs 53 [43, 59]%, P <.00010). During CPX, B-AA patients also had lower Vo2peak (14.6 ± 3.9 vs 17.6 ± 4.8 mL·kg−1·min−1, P <.0001). No differences were observed between B-AA and Caucasian in the minute ventilation/carbon dioxide production (Ve/Vco2) slope (P =.14). The difference in Vo2peak between B-AA and Caucasian was largely attenuated after adjusting for age, body mass index, CRP, N-terminal pro-brain natriuretic peptide, hemoglobin, LVEF, and peak HR (14.1: 95% CI, 13.2-14.9 vs 15.6: 95% CI, 14.4-16.8 mL·kg−1·min−1, P =.053). Conclusions: Directly measured Vo2peak was significantly lower in B-AA than in Caucasians with HF. This is largely explained by differences in clinical characteristics, whereas no significant differences were observed in the Ve/Vco2 slope.
AB - Purpose: Cardiopulmonary exercise testing (CPX) is a well-established assessment with important insight into prognosis and therapeutic efficacy in patients with heart failure (HF). Prior studies have identified several clinical differences between Black or African American (B-AA) and Caucasian patients with HF. Differences in key CPX responses between these two groups require further investigation. Methods: Using a database consisting of subjects with symptomatic HF who had undergone CPX for inclusion in various prospective randomized clinical trials, we identified 198 (n = 94 [47%] B-AA; n = 105 [53%] Caucasian) patients with a qualifying baseline CPX. Significant univariate predictors of peak oxygen uptake (Vo2peak) were included in a multivariate linear regression model. Results: When compared with Caucasian patients, B-AA were younger (mean ± SD = 54.8 ± 10.0 vs 57.9 ± 9.6 yr, P =.03), had higher C-reactive protein (CRP) (median [IQR] = 4.9 [2.3, 8.8] vs 1.9 [0.6, 5.5] mg/L, P <.0001), lower hemoglobin (13.0 ± 1.8 vs 13.8 ± 1.6 g/dL, P =.003), and lower left ventricular ejection fraction (LVEF) (40 [32, 51] vs 53 [43, 59]%, P <.00010). During CPX, B-AA patients also had lower Vo2peak (14.6 ± 3.9 vs 17.6 ± 4.8 mL·kg−1·min−1, P <.0001). No differences were observed between B-AA and Caucasian in the minute ventilation/carbon dioxide production (Ve/Vco2) slope (P =.14). The difference in Vo2peak between B-AA and Caucasian was largely attenuated after adjusting for age, body mass index, CRP, N-terminal pro-brain natriuretic peptide, hemoglobin, LVEF, and peak HR (14.1: 95% CI, 13.2-14.9 vs 15.6: 95% CI, 14.4-16.8 mL·kg−1·min−1, P =.053). Conclusions: Directly measured Vo2peak was significantly lower in B-AA than in Caucasians with HF. This is largely explained by differences in clinical characteristics, whereas no significant differences were observed in the Ve/Vco2 slope.
KW - Cardiorespiratory fitness
KW - Heart failure
KW - Peak oxygen uptake
KW - Prognosis
KW - Race
UR - http://www.scopus.com/inward/record.url?scp=85107880142&partnerID=8YFLogxK
U2 - https://doi.org/10.1097/HCR.0000000000000605
DO - https://doi.org/10.1097/HCR.0000000000000605
M3 - Article
C2 - 34793367
SN - 1932-7501
JO - Journal of Cardiopulmonary Rehabilitation and Prevention
JF - Journal of Cardiopulmonary Rehabilitation and Prevention
ER -