Determinants of Anaerobic Threshold at Each Stage of Renal Dysfunction in Patients With Heart Disease

Patients with heart disease have a low anaerobic threshold (AT), and the determinants of AT may differ, depending on the severity of renal dysfunction. This study aimed to verify the determinants of AT for each stage of renal function in patients with heart disease. We consecutively enrolled 250 patients with heart disease who underwent cardiopulmonary exercise testing in our institution. The patients were divided into 3 groups by their estimated glomerular filtration rate (eGFR): <45, 45 to 59, and >= 60 ml/min/1.73 m(2). A multi-variate linear regression analysis was performed to evaluate the independent determinants of AT for each group. In total, 201 patients were analyzed. AT decreased with the deterioration of renal function (eGFR <45, 10.9 +/- 2.1 vs eGFR 45 to 59, 12.4 +/- 2.5 vs eGFR >= 60, 14.0 +/- 2.6 ml/min/kg, p <0.001). In the eGFR <45 group, left ventricular ejection fraction and hemoglobin were significantly associated with AT (beta = 0.427, p = 0.006 and beta = 0.488, p = 0.002, respectively). In the eGFR 45 to 59 and >= 60 groups, Delta PETO2(end-tidal oxygen partial pressure from rest to AT) showed a significant association with AT (beta = 0.576, p <0.001 and beta = 0.308, p = 0.003, respectively). The determinants of AT depended on the stage of renal dysfunction in patients with heart disease. In conclusion, in the eGFR <45 group, the determinants of AT were left ventricular ejection fraction and hemoglobin, whereas in the eGFR 45 to 59 and eGFR >= 60 groups, the determinant of AT was Delta PETO2. (c) 2023 Elsevier Inc. All rights reserved.