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<p>Reduced peak oxygen uptake (V̇O₂peak) is a hallmark of heart failure (HF) and aging, but studies on V̇O₂peak in older HF&#xa0;patients are limited. We compared V̇O₂peak in older HF&#xa0;patients versus controls and investigated differences across the age continuum: young-old (YO, 60–69&#xa0;years), middle-old (MO, 70–79&#xa0;years), and oldest-old (OO, ≥ 80&#xa0;years). PubMed was searched (1967 May 2024) for studies meeting the following inclusion criteria: (1) HF&#xa0;patients with mean age ≥ 65&#xa0;years; (2) V̇O₂peak measured via maximal cardiopulmonary exercise testing, and (3) control group for aim 1. For aim 2, studies had to compare V̇O₂peak within the age-subgroups. Random-effects meta-analysis was conducted, comparing V̇O₂peak (primary aim, and Fick determinants when reported) between HF and controls (aim 1), and V̇O₂peak between older age-subgroups (aim 2). Results are presented as weighted mean differences (WMD) with 95% confidence intervals. From 2788 screened articles, 38 studies were included. For aim 1, 30 studies (HF: <i>n</i> = 1093, mean age 70&#xa0;years, 46% female; controls: <i>n</i> = 942, mean age 69&#xa0;years, 52% female) demonstrated a significantly lower V̇O₂peak in HF (WMD − 8.8&#xa0;mL/kg/min, [95% CI] − 10.3 to − 7.3&#xa0;mL/kg/min). In the subset of patients where Fick determinants were measured, peak cardiac output and heart rate were lower in HF versus controls. For aim 2, eight studies showed progressively lower V̇O₂peak with age: MO vs. YO (− 1.5&#xa0;mL/kg/min) and OO vs. MO (− 1.2&#xa0;mL/kg/min). Older HF patients exhibit significant V̇O₂peak reductions compared to controls, with progressively lower V̇O₂peak values observed across the older age continuum.</p> Graphical abstract <p></p>

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Peak oxygen uptake in older adults with heart failure: a systematic review and meta-analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年7月28日

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  • Veronika Schmid,
  • Sarah Paterson,
  • Christopher Weinkauf,
  • Jing Wang,
  • Corey R. Tomczak,
  • David Niederseer,
  • Jan Vontobel,
  • Daniel E. Forman,
  • Martin Halle,
  • Michael D. Nelson,
  • Stephen J. Foulkes,
  • Mark J. Haykowsky

摘要

Reduced peak oxygen uptake (V̇O₂peak) is a hallmark of heart failure (HF) and aging, but studies on V̇O₂peak in older HF patients are limited. We compared V̇O₂peak in older HF patients versus controls and investigated differences across the age continuum: young-old (YO, 60–69 years), middle-old (MO, 70–79 years), and oldest-old (OO, ≥ 80 years). PubMed was searched (1967 May 2024) for studies meeting the following inclusion criteria: (1) HF patients with mean age ≥ 65 years; (2) V̇O₂peak measured via maximal cardiopulmonary exercise testing, and (3) control group for aim 1. For aim 2, studies had to compare V̇O₂peak within the age-subgroups. Random-effects meta-analysis was conducted, comparing V̇O₂peak (primary aim, and Fick determinants when reported) between HF and controls (aim 1), and V̇O₂peak between older age-subgroups (aim 2). Results are presented as weighted mean differences (WMD) with 95% confidence intervals. From 2788 screened articles, 38 studies were included. For aim 1, 30 studies (HF: n = 1093, mean age 70 years, 46% female; controls: n = 942, mean age 69 years, 52% female) demonstrated a significantly lower V̇O₂peak in HF (WMD − 8.8 mL/kg/min, [95% CI] − 10.3 to − 7.3 mL/kg/min). In the subset of patients where Fick determinants were measured, peak cardiac output and heart rate were lower in HF versus controls. For aim 2, eight studies showed progressively lower V̇O₂peak with age: MO vs. YO (− 1.5 mL/kg/min) and OO vs. MO (− 1.2 mL/kg/min). Older HF patients exhibit significant V̇O₂peak reductions compared to controls, with progressively lower V̇O₂peak values observed across the older age continuum.

Graphical abstract