Department of Rehabilitation, Shinshu University Hospital, Nagano, Japan.
Department of Occupational Therapy, Health Science University, Yamanashi, Japan.
J Cardiol. 2020 Aug;76(2):139-146. doi: 10.1016/j.jjcc.2020.02.022. Epub 2020 Apr 12.
This study aimed to clarify the relationship between physical performance and prognosis of patients with heart failure using a meta-analysis given the inconsistencies in published studies regarding the same.
A total of 22 studies with 10,368 patients were included in this review. Hazard ratios were used for analysis, while meta-analysis was performed using the inverse-variance method. Among all physical performance tests reported in the literature, the six-minute walk distance (6MD) test was most frequently used. However, short physical performance battery (SPPB) and walking speed were more frequently used as outcomes among studies investigating patients with a higher mean age.
The results of our meta-analysis showed that 6MD cut-off values were significantly associated with mortality [hazard ratio (HR), 2.04; 95% confidence interval (CI), 1.48-2.83; p<0.001] and cardiovascular disease (HR, 2.18; 95% CI, 1.68-2.83; p<0.001). Although a number of studies have also reported on the relationship between other physical performance tests and prognosis, meta-analysis could not be performed. Our results revealed that physical performance was strongly correlated with prognosis among patients with heart failure.
Our meta-analysis showed a strong relationship between 6MD and prognosis. However, studies investigating more elderly patients have tended to more frequently utilize walking speed and SPPB as outcomes.
本研究旨在通过荟萃分析澄清心力衰竭患者的体能与预后之间的关系，因为关于这一问题的已发表研究结果存在不一致。
本综述共纳入了 22 项研究，共计 10368 例患者。采用风险比进行分析，同时使用逆方差法进行荟萃分析。在文献中报道的所有体能测试中，6 分钟步行距离（6MD）测试最常使用。但是，在研究年龄较大的患者时，更常使用短体适能电池（SPPB）和步行速度作为结果。
荟萃分析结果表明，6MD 截断值与死亡率显著相关[风险比（HR），2.04；95%置信区间（CI），1.48-2.83；p<0.001]和心血管疾病（HR，2.18；95% CI，1.68-2.83；p<0.001）。尽管许多研究也报道了其他体能测试与预后之间的关系，但无法进行荟萃分析。我们的结果表明，心力衰竭患者的体能与预后密切相关。
我们的荟萃分析显示 6MD 与预后之间存在很强的关系。然而，研究更老年患者的研究更倾向于将步行速度和 SPPB 作为结果。
