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. METHODS AND RESULTS: In a controlled, cross-sectional study, adults aged ≥50years 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±9.6years) were studied. Peak oxygen consumption (VO(2)) (15.4±4.2 vs. 23.4±6.6ml O(2)·kg(-1)·min(-1), p<0.0001), 1RM (154.8±52.0 vs. 195.3±56.8kg, p<0.01) and power (226.4±99.2 vs. 313.3±130.6, p<0.01) were lower in HFREF vs. controls. 1RM 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 (≥30kg/m(2)) body mass index (BMI), 1RM and fat mass were significantly greater than those with lower (<30kg/m(2)) BMIs. Correlations between 1RM 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. CONCLUSION: Increased adiposity correlates with relatively greater strength in HFREF patients which may explain some of the clinical benefits that result from obesity.
International journal of cardiology 06/2012; · 7.08 Impact Factor