P4539Android to gynoid fat ratio and its association with functional capacity in male patients with heart failure

Abstract Background Obesity may have a protective role in patients with heart failure with reduced ejection fraction (HFrEF), a phenomenon known as obesity paradox. However, some patients can also present sarcopenic obesity with similar exercise intolerance as lean patients with muscle wasting. However, the impact of body fat distribution on exercise intolerance in HFrEF is unknown. Purpose To study the association between android to gynoid fat ratio and functional capacity (VO2 peak) in male patients with HFrEF. Methods We enrolled 118 male with HFrEF with left ventricular ejection fraction (LVEF) 0.55 (P0.55 (18.7±5.3 vs. 22.5±6.1 mL/kg/min, P0.05). On the other hand, HDL, total testosterone, free testosterone, and DHEA were lower in patients with A/G ratio >0.55 (P0.55 to be independently associated with reduced peak VO2 (L/min) adjusted for age, BMI, LVEF, presence of sarcopenia, anabolic hormones, and haemoglobin (odds ratio 3.895, 95% CI 1.030–14.730, p=0.045). Conclusion Our data suggest that body fat distribution, particularly android and gynoid fat composition, might have an important adverse role on functional capacity in male patients with HFrEF. Acknowledgement/