Relationship of age and exercise performance in patients with heart failure: The HF-ACTION study

Abstract

Background: More than three fourths of patients with heart failure (HF) are 65 years and older, and older age is associated with worse symptoms and prognoses than is younger age. Reduced exercise capacity is a chief HF complaint and indicates poorer prognosis, especially among elderly persons, but the mechanisms underlying functional decline in older patients with HF are largely unknown. Methods: Baseline cardiopulmonary exercise testing data from the HF-ACTION trial were assessed to clarify age effects on peak oxygen consumption (VO2) and ventilation-carbon dioxide production (VE/VCO2) slope. Results: Among 2,331 New York Heart Association class II-IV patients with HF, increased age corresponded to decreased peak VO2 (-0.14 mL kg-1 min-1 per year >40 years; P 70 years; P < .0001). In a multivariable model with 34 other potential determinants, age was the strongest independent predictor of peak VO2 (partial R2 0.130, total R2 0.392; P