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. 2009 Nov;57(11):2055-61.
doi: 10.1111/j.1532-5415.2009.02495.x. Epub 2009 Sep 28.

Prediction of cardiorespiratory fitness in older men infected with the human immunodeficiency virus: clinical factors and value of the six-minute walk distance

Krisann K Oursler  1 , Leslie I Katzel, Barbara A Smith, Wayne B Scott, David W Russ, John D Sorkin
Affiliations

Prediction of cardiorespiratory fitness in older men infected with the human immunodeficiency virus: clinical factors and value of the six-minute walk distance

Krisann K Oursler et al. J Am Geriatr Soc. 2009 Nov.

Abstract

Objectives: To investigate factors related to cardiorespiratory fitness in older human immunodeficiency virus (HIV)-infected patients and to explore the utility of 6-minute walk distance (6-MWD) in measuring fitness.

Design: Cross-sectional study in clinic-based cohort.

Setting: Veterans Affairs Medical Center, Baltimore, Maryland.

Participants: Forty-three HIV-infected men, median age 57 (range 50-82), without recent acquired immunodeficiency syndrome-related illness and receiving antiretroviral (ARV) therapy.

Measurements: Peak oxygen utilization (VO(2)peak) according to treadmill graded exercise testing, 6-MWD, grip strength, quadriceps maximum voluntary isometric contraction, cross-sectional area, muscle quality, and muscle adiposity.

Results: There was a moderate correlation between VO(2)peak (mean +/- SD; 18.4 +/- 5.6 mL/kg per minute) and 6-MWD (514 +/- 91 m) (r=0.60, P<.001). VO(2)peak was lower in subjects with hypertension (16%, P<.01) and moderate anemia (hemoglobin 10-13 gm/dL; 15%, P=.09) than in subjects without these conditions. CD4 cell count (median 356 cells/mL, range 20-1,401) and HIV-1 viral load (84% nondetectable) were not related to VO(2)peak. Among muscle parameters, only grip strength was an independent predictor of VO(2)peak. Estimation of VO(2)peak using linear regression, including age, 6-MWD, grip strength, and hypertension as independent variables, explained 61% of the variance in VO(2)peak.

Conclusion: Non-AIDS-related comorbidity predicts cardiorespiratory fitness in older HIV-infected men receiving ARV therapy. The 6-MWD is a valuable measure of fitness in this patient population, but a larger study with diverse subjects is needed.

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Conflict of interest statement

Conflict of Interest: The editor in chief has reviewed the conflict of interest checklist provided by the authors and has determined that the authors have no financial or any other kind of personal conflicts with this paper. Dr. Oursler’s effort on this research was supported by National Institutes of Health (NIH) grant K23 AG024896. Dr. Scott’s effort on this research was supported by a NIH T32 grant. The research was supported by National Institute on Aging (NIA) University of Maryland Claude D. Pepper Older Americans Independence Center P60-AG12583 (Drs. Oursler, Katzel, Russ, and Sorkin), University of Maryland General Clinical Research Center (M01 RR 16500), National Center for Research Resources, National Center for Rehabilitation Research T32 HD041899-01A1 (Dr. Scott), and Baltimore VA Geriatric Research, Clinical and Education Center (Drs. Katzel and Sorkin).

Figures

Figure 1
Figure 1
Correlation between peak oxygen utilization (VO2peak) and 6-minute walk distance, hand-grip strength, quadriceps strength, and cross-sectional area. MVC = maximum isometric voluntary contraction.
Figure 2
Figure 2
Plot of measured peak oxygen utilization (VO2peak; L/min) according to model-predicted VO2peak (L/min) estimated using the final multivariate model (Table 3, model 7). The diagonal line represents the line of perfect agreement.
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