Relation Between Body Mass Index, Exercise Training, and Outcomes in Chronic Systolic Heart Failure

Exercise training (ET) in heart failure (HF), as demonstrated in the HF-ACTION trial, was associated with improved exercise tolerance and health status, and a trend towards reduced mortality or hospitalizations. This analysis of the HF-ACTION cohort examines the effect of ET in overweight and obese...

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Published in:The American journal of cardiology 2011-09, Vol.108 (12), p.1754-1759
Main Authors: Horwich, Tamara B, Broderick, Samuel, Chen, Leway, McCullough, Peter A., Strzelczyk, Theresa, Kitzman, Dalane W., Fletcher, Gerald, Safford, Robert E., Ewald, Gregory, Fine, Lawrence J., Ellis, Stephen J, Fonarow, Gregg C
Format: Article
Language:English
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Summary:Exercise training (ET) in heart failure (HF), as demonstrated in the HF-ACTION trial, was associated with improved exercise tolerance and health status, and a trend towards reduced mortality or hospitalizations. This analysis of the HF-ACTION cohort examines the effect of ET in overweight and obese compared to normal HF subjects. 2,314 of 2,331 systolic HF subjects randomized to aerobic ET vs. usual care in HF-ACTION were analyzed to determine the effect of ET on all cause mortality, hospitalizations, exercise parameters, quality of life (QOL), and body weight changes by subgroups of body mass index (BMI). Strata included normal weight (BMI 18.5 – 24.9 kg/m 2 ), overweight (BMI 25.0 – 29.9 kg/m 2 ), obese I (BMI 30 – 34.9 kg/m 2 ), obese II (BMI 35-39.9 kg/m 2 ), and obese III (BMI ≥ 40 kg/m 2 ). At enrollment, 19.4% of subjects were normal weight, 31.3% overweight, and 49.4% obese. Higher BMI was associated with a non-significant increase in all cause mortality or hospitalization. ET was associated with non-significant reductions in all cause mortality or hospitalization in each weight category (HR 0.98, 0.95, 0.92, 0.89, and 0.86 in normal weight, overweight, obese I, obese II, and obese III categories, respectively [all p>0.05]). Modeled improvement in exercise capacity (peak oxygen consumption) and QOL in the ET group was seen in all BMI categories. In conclusion, aerobic ET in HF was associated with a non-significant trend towards decreased mortality and hospitalizations and a significant improvement in QOL across the range of BMI categories.
ISSN:0002-9149
1879-1913
DOI:10.1016/j.amjcard.2011.07.051