title: Adiposity facilitates increased strength capacity in heart failure patients with reduced ejection fraction.
abstract: BACKGROUND
  Obesity is associated with relatively improved prognosis among heart failure (HF) patients. Mechanisms explaining this so-called "obesity paradox" have been unclear. We hypothesized that increased adiposity may contribute to increased strength capacity, and may thereby facilitate clinical benefits.
  
  
  RESULTS
  In a controlled, cross-sectional study, adults aged ≥ 50 years with HF with reduced ejection fraction (HFREF) (LVEF ≤ 40%) were compared to age matched controls. Body composition was determined by dual-energy X-ray absorptiometry (DXA). Aerobic (cardiopulmonary exercise testing), maximum strength (one repetition maximum [1RM]), and power (submaximal resistance/time) were assessed. 70 adults (31 HFREF, 39 controls; mean age 66.2 ± 9.6 years) were studied. Peak oxygen consumption (VO2) (15.4 ± 4.2 vs. 23.4 ± 6.6 ml O2 · kg(-1) · min(-1), p<0.0001), 1RM (154.8 ± 52.0 vs. 195.3 ± 56.8 kg, p<0.01) and power (226.4 ± 99.2 vs. 313.3 ± 130.6, p<0.01) were lower in HFREF vs. controls. 1 RM correlated with total fat (r=0.56, p<0.01), leg fat (r=0.45, p<0.05) and arm fat (r=0.39, p<0.05) in HFREF. Moreover, among HFREF patients with a high (≥ 30 kg/m(2)) body mass index (BMI), 1RM and fat mass were significantly greater than those with lower (<30 kg/m(2)) BMIs. Correlations between 1 RM and total fat (r=0.65, p<0.05) and leg fat (r=0.64, p<0.05) were particularly notable in the high BMI subgroup.
  
  
  CONCLUSIONS
  Increased adiposity correlates with relatively greater strength in HFREF patients which may explain some of the clinical benefits that result from obesity.
authors: New England Geriatric Research, Education, and Clinical Center, VA Boston Healthcare System, Boston, MA, United States.
authors: Alexandra
authors: A
authors: Zavin
authors: Karla
authors: K
authors: Daniels
authors: Ross
authors: R
authors: Arena
authors: Kelly
authors: K
authors: Allsup
authors: Antonio
authors: A
authors: Lazzari
authors: Jacob
authors: J
authors: Joseph
authors: P Christian
authors: PC
authors: Schulze
authors: Stewart H
authors: SH
authors: Lecker
authors: Daniel E
authors: DE
authors: Forman
mesh_terms: D050154:Adiposity / Q000502:physiology*; D000368:Aged; D003430:Cross-Sectional Studies; D005080:Exercise Test / Q000379:methods; D006333:Heart Failure / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D010101:Oxygen Consumption / Q000502:physiology; D013318:Stroke Volume / Q000502:physiology*