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Body Mass Index-Adjusted Rectus Femoris Muscle Thickness as a Simple Indicator for Exercise Tolerance in Patients
Ryuji Suyama1,2, Masahiko Kato3, Shinobu Sugihara4
1Doctoral Course in Integrated Medical Sciences, Graduate School of Medical Sciences, Tottori University Tottori Japan.
Background:
We evaluated the association between rectus femoris muscle thickness adjusted by body mass index (RFT/BMI) and oxygen uptake at anaerobic threshold (AT-V̇O2) in patients with heart failure (HF) to assess whether RFT/BMI was associated with AT-V̇O2, a key indicator of exercise tolerance and a known prognostic factor in HF.
Methods And Results:
In this retrospective cross-sectional study, 103 patients with HF who underwent ultrasound-derived RFT measurement and cardiopulmonary exercise testing (CPX) were included. RFT/BMI was examined using multivariable linear regression and restricted cubic spline analysis. Receiver operating characteristic curve analysis identified optimal RFT/BMI cutoffs, and propensity score-adjusted modified Poisson regression assessed associations with subthreshold AT-V̇O2. RFT/BMI was independently associated with AT-V̇O2 (β=0.62, 95% confidence interval (CI): 0.45 to 0.79, P<0.001), with a significant nonlinear relationship. Cutoffs of 0.55 and 0.69 discriminated AT-V̇O2 ≥10.5 and ≥14.0 mL/min/kg, with AUCs of 0.89 and 0.75, respectively. In the modified Poisson regression, RFT/BMI ≥0.55 and ≥0.69 was associated with lower risk of AT-V̇O2 <10.5 mL/min/kg (aRR=0.22, 95% CI: 0.09 to 0.53, P=0.001) and <14.0 mL/min/kg (aRR=0.45, 95% CI: 0.28 to 0.73, P=0.001).
Conclusions:
Ultrasound-derived RFT/BMI was associated with AT-V̇O2 in patients with HF, and thus may provide supportive information on exercise tolerance when CPX is not feasible.
