Leptin and the Ventilatory Response to Exercise in Heart Failure

Research output: Contribution to journalArticle

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Abstract

OBJECTIVES: The aim of the study was to test the hypothesis that leptin is involved in the regulation of ventilatory responses to exercise in chronic heart failure (CHF). BACKGROUND: Exercise-induced hyperventilation is a negative prognostic factor in CHF. Studies in animals suggest that leptin, a hormone secreted by adipocytes, contributes to the regulation of respiration. Plasma leptin levels are elevated in non-cachectic CHF, suggesting the possibility that leptin might be involved in dysregulation of ventilation in CHF. METHODS: We studied 50 patients with stable CHF without cachexia. All subjects underwent anthropometric measurements, resting echocardiography, pulmonary function tests, and a cardiopulmonary exercise test. The ventilatory response to exercise was assessed by calculating the VE/VCO2 and VE/VO2 slopes (VE = ventilation per unit time, VCO2 = carbon dioxide production, VO2 = oxygen consumption). RESULTS: Using a multiple regression model, leptin was significantly and positively correlated with both VE/VCO2 slope (regression coefficient = 0.87, F = 39.32, p < 0.001) and VE/VO2 slope (regression coefficient = 0.84, F = 24.04, p < 0.001). This correlation was independent of age, gender, body mass index, body fat, ejection fraction, New York Heart Association functional class, pulmonary function, plasma norepinephrine, angiotensin II, brain natriuretic peptide levels, and medications. Also, the greatest VE/VCO 2 slope was seen in subjects in the highest tertile of leptin. CONCLUSIONS: Leptin is an independent predictor of VE/VCO2 slope in heart failure, and may be a link between metabolic, cardiovascular, and respiratory abnormalities in CHF.

Original languageEnglish (US)
Pages (from-to)1644-1649
Number of pages6
JournalJournal of the American College of Cardiology
Volume42
Issue number9
DOIs
StatePublished - Nov 5 2003

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Leptin
Heart Failure
Exercise
Ventilation
Cardiovascular Abnormalities
Cachexia
Hyperventilation
Brain Natriuretic Peptide
Respiratory Function Tests
Exercise Test
Adipocytes
Carbon Dioxide
Oxygen Consumption
Angiotensin II
Echocardiography
Adipose Tissue
Norepinephrine
Respiration
Body Mass Index
Hormones

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Leptin and the Ventilatory Response to Exercise in Heart Failure. / Wolk, Robert; Johnson, Bruce David; Somers, Virend.

In: Journal of the American College of Cardiology, Vol. 42, No. 9, 05.11.2003, p. 1644-1649.

Research output: Contribution to journalArticle

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abstract = "OBJECTIVES: The aim of the study was to test the hypothesis that leptin is involved in the regulation of ventilatory responses to exercise in chronic heart failure (CHF). BACKGROUND: Exercise-induced hyperventilation is a negative prognostic factor in CHF. Studies in animals suggest that leptin, a hormone secreted by adipocytes, contributes to the regulation of respiration. Plasma leptin levels are elevated in non-cachectic CHF, suggesting the possibility that leptin might be involved in dysregulation of ventilation in CHF. METHODS: We studied 50 patients with stable CHF without cachexia. All subjects underwent anthropometric measurements, resting echocardiography, pulmonary function tests, and a cardiopulmonary exercise test. The ventilatory response to exercise was assessed by calculating the VE/VCO2 and VE/VO2 slopes (VE = ventilation per unit time, VCO2 = carbon dioxide production, VO2 = oxygen consumption). RESULTS: Using a multiple regression model, leptin was significantly and positively correlated with both VE/VCO2 slope (regression coefficient = 0.87, F = 39.32, p < 0.001) and VE/VO2 slope (regression coefficient = 0.84, F = 24.04, p < 0.001). This correlation was independent of age, gender, body mass index, body fat, ejection fraction, New York Heart Association functional class, pulmonary function, plasma norepinephrine, angiotensin II, brain natriuretic peptide levels, and medications. Also, the greatest VE/VCO 2 slope was seen in subjects in the highest tertile of leptin. CONCLUSIONS: Leptin is an independent predictor of VE/VCO2 slope in heart failure, and may be a link between metabolic, cardiovascular, and respiratory abnormalities in CHF.",
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