Elkhatib Wiaam, Olson Thomas
Mayo Clinic Department of Cardiovascular Disease.
medRxiv. 2025 Aug 26:2025.08.22.25334270. doi: 10.1101/2025.08.22.25334270.
Peak oxygen uptake (VO peak), standardized to total body mass (ml/kg/min) is a predictor of morbidity and mortality in cardiovascular disease patients. However, subsets of individuals undergoing exercise based cardiac rehabilitation (CR) show no improvement or reduction in VO peak despite improvement in other functional measures. Our aim is to assess the influence of CR on lean mass, and the effect of body composition compared to total body mass changes on peak VO following CR.
This pre-post intervention study included adults >18 years old who completed CR between 2015-2022 at Mayo Clinic, Rochester. All patients completed both dual energy X-ray absorptiometry (DXA) and cardiopulmonary exercise testing (CPET) for measurement of body composition (total mass and lean mass) and VO peak pre-post CR. Improvement in VO peak was defined as positive percent change. Descriptive statistics, paired t-tests, univariable and multivariable linear regression modeling were performed.
Of 140 subjects, 19.3% were female and 96.4% White with a mean (SD) age of 63 (12.5) years, BMI of 30.2 (5.82), and a mean of 27.1 (11.7) completed number CR sessions. Pre-post CR total body mass loss was -1.28 (3.18) kg and lean mass gain was 0.84 (2.86) kg. All changes were statistically significant (p<0.05). Pre-post CR VO peak in absolute units had a percent change increase of 6.52 (13.1) mL/min, relative (corrected for total body mass) increase of 8.24 (13.6) mL/kg/min, and relative to lean mass increase of 5.73 (13.4) mL/lean-kg/min. Pre-post percentage of subjects with a positive change in peak VO in absolute units was 70%, relative was 75%, and relative to lean mass was 67.9%. Multivariable regression showed statistical significance in peak VO percent change for all units when adjusted for pre-CR peak VO.
Our findings demonstrate significant increases in lean mass and VO peak following CR, with larger improvements reflected in units adjusted for total mass compared to other methods. These data suggest the reporting methodology for change in VO peak following CR impact overall results.
以体重标准化的峰值摄氧量（VO₂峰值）是心血管疾病患者发病和死亡的预测指标。然而，在接受基于运动的心脏康复（CR）的个体亚组中，尽管其他功能指标有所改善，但VO₂峰值并未改善或降低。我们的目的是评估CR对瘦体重的影响，以及与CR后总体重变化相比，身体成分对VO₂峰值的影响。
这项干预前后研究纳入了2015年至2022年在罗切斯特梅奥诊所完成CR的18岁以上成年人。所有患者在CR前后均完成了双能X线吸收法（DXA）和心肺运动测试（CPET），以测量身体成分（总体重和瘦体重）和VO₂峰值。VO₂峰值的改善定义为正百分比变化。进行了描述性统计、配对t检验、单变量和多变量线性回归建模。
在140名受试者中，19.3%为女性，96.4%为白人，平均（标准差）年龄为63（12.5）岁，体重指数为30.2（5.82），平均完成CR疗程数为27.1（11.7）次。CR前后总体重减轻-1.28（3.18）kg，瘦体重增加0.84（2.86）kg。所有变化均具有统计学意义（p<0.05）。CR前后VO₂峰值的绝对单位变化百分比增加了6.52（13.1）mL/min，相对（校正总体重）增加了8.24（13.6）mL/kg/min，相对于瘦体重增加了5.73（13.4）mL/瘦体重-kg/min。VO₂峰值绝对单位变化为正的受试者前后百分比为70%，相对百分比为75%，相对于瘦体重为67.9%。多变量回归显示，在调整CR前VO₂峰值后，所有单位的VO₂峰值百分比变化均具有统计学意义。
我们的研究结果表明，CR后瘦体重和VO₂峰值显著增加，与其他方法相比，在调整总体重的单位中改善更为明显。这些数据表明，CR后VO₂峰值变化的报告方法会影响总体结果。
