cigarette smoking are traditional systemic risk factors, 10 and the low-density lipoprotein-cholesterol (LDL-C) level is a well-established molecular risk factor. 11 A meta-analysis of 4 randomized trials using conventional IVUS revealed that a decrease in both the LDL-C level and the LDL-C/ high-density lipoprotein-cholesterol (HDL-C) ratio (L/H ratio) after statin treatment was associated with regression of the total atheroma volume in patients with CVD. 12 Although the lipid component of coronary plaques as evaluated by IB-IVUS more precisely reflects the vulnerability of coronary plaques and predicts clinical outcomes compared with evaluation of the atheroma volume using conventional IVUS, 7,13 it has not been determined which coronary risk factors are associated with the serial changes in the lipid component of coronary plaques evaluated by IB-IVUS. Accordingly, we sought to investigate this in the I n the past decade, cardiovascular disease (CVD) has emerged as the leading cause of death worldwide. Most cases of acute coronary syndrome (ACS), which is one of the most traumatic events in CVD, are triggered by the rupture of a vulnerable plaque followed by thrombosis formation at the rupture site. 1,2 Vulnerable plaques are characterized by a large, lipid-enriched necrotic core overlaid with a thin fibrous cap. 3 Pathological studies have revealed that the size of the lipid component of coronary plaques is strongly associated with their vulnerability. 4-6 Integrated backscatter intravascular ultrasound (IB-IVUS) is capable of assessing the lipid component of coronary plaques and can evaluate serial changes in the lipid component during drug interventions. 5,7-9There are many risk factors for the development of CVD; hypertension, dyslipidemia, diabetes, obesity, and
Skeletal muscle mass is associated with exercise tolerance in patients with chronic heart failure (CHF). Anthropometric indicators are used to evaluate skeletal muscle mass, as these can be easily assessed in clinical practice. However, the association between anthropometric indicators and exercise tolerance is unclear. This study aimed to investigate the association between anthropometric indicators and exercise tolerance in CHF patients.
Methods:We evaluated 69 patients with CHF. Mid-arm circumference, mid-arm muscle circumference (MAMC), calf circumference and body mass index were measured as the anthropometric indicators. Exercise tolerance was evaluated according to the peak oxygen uptake (VO 2 ). Correlation analyses were carried out to determine the association between peak VO 2 and anthropometric indicators. Furthermore, univariate and multiple regression analyses were carried out using peak VO 2 as the dependent variable, and age, male, left ventricular ejection fraction, angiotensin II receptor blocker or angiotensin converting enzyme inhibitor, diuretics, B-type natriuretic peptide, estimated glomerular filtration rate, hemoglobin and anthropometric indicators as the independent variables.Results: There were significant positive correlations between the peak VO 2 and mid-arm circumference (r s = 0.378, P = 0.001), MAMC (r = 0.634, P < 0.001) and calf circumference (r = 0.292, P = 0.015). In multiple regression analysis, MAMC (β = 0.721, P < 0.001) and estimated glomerular filtration rate (β = 0.279, P = 0.007) were independent factors associated with peak VO 2 .Conclusions: MAMC is independently associated with peak VO 2 in CHF patients. Thus, MAMC could be an indicator of exercise tolerance, which is closely related to the severity and prognosis of CHF.
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