{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T15:51:25Z","timestamp":1791993085859,"version":"4.4.0"},"reference-count":26,"publisher":"S. Karger AG","issue":"3","license":[{"start":{"date-parts":[[2010,1,1]],"date-time":"2010-01-01T00:00:00Z","timestamp":1262304000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"},{"start":{"date-parts":[[2010,1,1]],"date-time":"2010-01-01T00:00:00Z","timestamp":1262304000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Nephrol"],"published-print":{"date-parts":[[2010]]},"abstract":"<i>Background:<\/i> Decreased renal function has been consistently associated with increased mortality among patients with systolic heart failure. The relationship between estimated glomerular filtration rate (eGFR) and other high-risk features including reduced cardiorespiratory fitness has not been previously reported in this patient population. <i>Methods:<\/i> The HF-ACTION trial was a prospective, randomized trial of exercise therapy versus usual care in patients with systolic heart failure. Patients with class 2\u20134 heart failure and a left ventricular ejection fraction of \u226435% were recruited. Serum creatinine was measured up to 1 year prior to entry. The 4-variable modified Modification of Diet in Renal Disease equation was used to calculate eGFR. Peak oxygen consumption (peak VO<sub>2<\/sub>) was directly measured using gas exchange analysis during progressive exercise testing to volitional fatigue or adverse signs\/symptoms. <i>Results:<\/i> Of 2,091 subjects (mean age 59 \u00b1 13 years, with serum creatinine available at baseline), 72% were men, and 61, 33, and 5% were Caucasians, African Americans, and others, respectively. Older age, diabetes, and hypertension were all more frequent with declining eGFR. The Pearson correlation between eGFR and peak VO<sub>2<\/sub> was 0.22 (p < 0.0001). Age was negatively correlated with both eGFR (r = \u20130.44, p < 0.0001) and peak VO<sub>2<\/sub> (r = \u20130.27, p < 0.0001). The peak VO<sub>2<\/sub> tended to decline across decreasing levels of eGFR. Individuals with an eGFR <30 ml\/min\/1.73 m<sup>2<\/sup> had, on average, 2.1 high-risk features including peak VO<sub>2<\/sub> <14 ml\/kg\/min, age >75 years, diabetes, and functional class 3\u20134 symptoms. Conversely, those with an eGFR >90 ml\/min\/1.73 m<sup>2<\/sup> had relatively few (1.0) high-risk characteristics. <i>Conclusions:<\/i> Reduced renal filtration is associated with impaired cardiorespiratory fitness and a clustering of high-risk features in systolic heart failure patients which portend a more complicated course and higher all-cause mortality.<\/jats:p>","DOI":"10.1159\/000317544","type":"journal-article","created":{"date-parts":[[2010,7,22]],"date-time":"2010-07-22T07:08:09Z","timestamp":1279782489000},"page":"226-233","source":"Crossref","is-referenced-by-count":24,"title":["Impact of Reduced Kidney Function on Cardiopulmonary Fitness in Patients with Systolic Heart Failure"],"prefix":"10.1159","volume":"32","author":[{"given":"Peter A.","family":"McCullough","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barry A.","family":"Franklin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Leifer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregg C.","family":"Fonarow","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the HF-ACTION Investigators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2010,7,22]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1016%2FS0735-1097%2801%2901700-4"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1681%2FASN.2009010041"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1053%2Fj.ajkd.2007.12.016"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1053%2Fj.ajkd.2007.12.013"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1111%2Fj.1559-4572.2008.00001.x"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1016%2Fj.ecl.2008.06.004"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1053%2Fj.ajkd.2007.06.013"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1016%2Fj.jacc.2005.11.084"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1016%2Fj.ahj.2006.11.007"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1001%2Fjama.2009.454"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1016%2Fj.amjcard.2008.04.047"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1378%2Fchest.94.5.931"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1038%2Fsj.ki.5002343"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1093%2Feurheartj%2Fehp507"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1136%2Fhrt.2003.015503"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1007%2Fs10741-006-9190-8"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1093%2Feurjhf%2Fhfp093"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1038%2Fnrcardio.2009.121"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1111%2Fj.1440-1797.2009.01119.x"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1016%2Fj.jacc.2004.11.061"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.2165%2F00007256-200333120-00002"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1681%2FASN.2008080860"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1016%2Fj.atherosclerosis.2008.08.016"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1016%2FS0735-1097%2802%2902955-8"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1016%2Fj.amjcard.2004.06.041"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.2215%2FCJN.03670807"}],"container-title":["American Journal of Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/317544","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/317544","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T19:27:35Z","timestamp":1745436455000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000317544"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2010]]},"references-count":26,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2010,9,1]]},"published-print":{"date-parts":[[2010,9,16]]}},"URL":"https:\/\/doi.org\/10.1159\/000317544","archive":["Portico"],"relation":{},"ISSN":["0250-8095","1421-9670"],"issn-type":[{"value":"0250-8095","type":"print"},{"value":"1421-9670","type":"electronic"}],"subject":[],"published":{"date-parts":[[2010]]}}}