{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T21:26:37Z","timestamp":1769117197703,"version":"3.49.0"},"reference-count":31,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2013,6,21]],"date-time":"2013-06-21T00:00:00Z","timestamp":1371772800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J cachexia sarcopenia muscle"],"published-print":{"date-parts":[[2013,12]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Respiratory muscle (RM) function predicts prognosis in non\u2010cachectic patients with chronic heart failure (CHF). We hypothesized that weakness of RM (maximum inspiratory mouth occlusion pressure, Pi<jats:sub>max<\/jats:sub>) is a function of body mass index, and that outcome is more a function of BMI than of Pi<jats:sub>max<\/jats:sub> or ventilatory drive (P0.1).<\/jats:p><\/jats:sec><jats:sec><jats:title>Subjects and methods<\/jats:title><jats:p>We enrolled 249 CHF patients (11.2\u00a0% female, median age 54.2\u00a0years) at the German Heart Institute Berlin. Patients were in NYHA classes I\/II\/III\/IV by <jats:italic>n<\/jats:italic>\u2009=\u200916\/90\/108\/35. All patients underwent tests of pulmonary function, RM (Pi<jats:sub>max<\/jats:sub>, P0.1), cardiopulmonary exercise testing (peakVO2, VE\/VCO2\u2010slope), and right heart catheterization.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Mean follow\u2010up time was 18 (1\u201336) months, 47 patients (18.9\u00a0%) died or underwent cardiac assist implantation. Pi<jats:sub>max<\/jats:sub> correlated weakly with BMI (<jats:italic>r<\/jats:italic>\u2009=\u20090.19), peakVO2 (<jats:italic>r<\/jats:italic>\u2009=\u20090.15), and FEV1 (<jats:italic>r<\/jats:italic>\u2009=\u20090.34, all <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.02), and was lower in females compared to males (3.9\u2009\u00b1\u20091.7 vs. 6.6\u2009\u00b1\u20092.7\u00a0kPa; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). P0.1 correlated with pulmonary pressure (rho\u2009=\u20090.2; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01) and peakVO2 (rho\u2009=\u2009\u22120.14; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.02). Neither Pi<jats:sub>max<\/jats:sub> [hazard ratio (HR) 0.98; confidence interval (CI) 0.88\u20131.08] nor P0.1 (HR 0.52; 0.06\u20134.6) predicted survival. Multivariate regression analysis revealed gender, BMI, and FEV1 as cofactors of Pi<jats:sub>max<\/jats:sub>, with only BMI (HR 0.87; CI 0.80\u20130.95) predicting survival independently. The lowest quintile in BMI had the worst outcome (log\u2010rank <jats:italic>\u03c7<\/jats:italic>\u00b2\u2009=\u200913.5, <jats:italic>p<\/jats:italic>\u2009=\u20090.009).<\/jats:p><\/jats:sec><jats:sec><jats:title>Summary<\/jats:title><jats:p>In CHF patients including cachexia and NYHA IV, Pi<jats:sub>max<\/jats:sub> does not predict survival. Pi<jats:sub>max<\/jats:sub> depends on gender, BMI, FEV1, and peakVO2, with only BMI and peakVO2 predicting survival. The impaired Pi<jats:sub>max<\/jats:sub> in CHF might be a result of catabolism and weight loss and is not a predictive factor in itself.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s13539-013-0109-7","type":"journal-article","created":{"date-parts":[[2013,6,20]],"date-time":"2013-06-20T10:43:46Z","timestamp":1371725026000},"page":"277-285","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Relation of respiratory muscle strength, cachexia and survival in severe chronic heart failure"],"prefix":"10.1002","volume":"4","author":[{"given":"Dirk","family":"Habedank","sequence":"first","affiliation":[{"name":"Department of Cardiology DRK Kliniken Berlin K\u00f6penick  S.-Allende-Str. 2-8 12559 Berlin"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F. Joachim","family":"Meyer","sequence":"additional","affiliation":[{"name":"Department of Pneumology and Gastroenterology Munich Municipal Hospital  M\u00fcnchen"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roland","family":"Hetzer","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery Deutsches Herzzentrum  Berlin"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan D.","family":"Anker","sequence":"additional","affiliation":[{"name":"Centre for Clinical and Basic Research IRCCS San Raffaele  Rome"},{"name":"Department of Cardiology Applied Cachexia Research, Charit\u00e9 Campus Virchow  Berlin"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ralf","family":"Ewert","sequence":"additional","affiliation":[{"name":"Department of Cardiology University of Greifswald  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