Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
Clin Cardiol. 2021 Feb;44(2):244-251. doi: 10.1002/clc.23535. Epub 2020 Dec 25.
Limited information is available regarding the prognostic potential of muscular fitness parameters in heart failure (HF) with reduced ejection fraction (HFrEF).
We aimed to investigate the predictive potential of knee extensor muscle strength and power on rehospitalization and evaluate the correlation between exercise capacity and muscular fitness in patients newly diagnosed with HFrEF.
Ninety nine patients hospitalized with a new diagnosis of HF were recruited (64 men; aged 58.7 years [standard deviation (SD), 13.2 years]; 32.3% ischemic; ejection fraction, 28% [SD, 8%]). The inclusion criteria were left ventricular ejection fraction <40% and sufficient clinical stability to undergo exercise testing. Aerobic exercise capacity was measured with cardiopulmonary exercise testing. Knee extensor maximal voluntary isometric contraction (MVIC) and muscle power (MP) were measured using the Baltimore therapeutic equipment system. The clinical outcome was HF rehospitalization.
Over a mean follow-up period of 1709 ± 502 days, 39 patients were rehospitalized due to HF exacerbation. HF rehospitalization was more probable for patients with diabetes and lower oxygen uptake at peak exercise (peak VO ), knee extensor MVIC, and MP. The Kaplan-Meier survival analysis revealed significantly different cumulative HF rehospitalization rates according to the tertiles of peak VO (P = 0.005) and MP (P = 0.002). Multivariable Cox proportional hazard model showed that the lowest tertiles of peak VO (hazard ratio (HR), 6.26; 95% confidence interval (CI), 1.93-20.27); and MP (HR, 5.29; 95% CI, 1.05-26.53) were associated with HF rehospitalization. Knee extensor muscle power was an independent predictor for rehospitalization in patients with HFrEF.
Knee extensor muscle power was an independent predictor for rehospitalization in patients with HFrEF.
关于射血分数降低的心力衰竭（HFrEF）患者肌肉功能参数的预后潜力，相关信息有限。
我们旨在研究股四头肌力量和功率对再住院的预测潜力，并评估新诊断为 HFrEF 的患者运动能力与肌肉功能之间的相关性。
招募了 99 名因新诊断 HF 住院的患者（64 名男性；年龄 58.7±13.2 岁；32.3%为缺血性；射血分数 28%±8%）。纳入标准为左心室射血分数<40%，且有足够的临床稳定性进行运动测试。心肺运动测试测量有氧运动能力。使用巴尔的摩治疗设备系统测量股四头肌最大等长收缩（MVIC）和肌肉力量（MP）。临床结局为 HF 再住院。
在平均 1709±502 天的随访期间，39 名患者因 HF 恶化而再次住院。患有糖尿病和峰值运动时摄氧量（peak VO ）、股四头肌 MVIC 和 MP 较低的患者更有可能再次住院。Kaplan-Meier 生存分析显示，根据 peak VO （P=0.005）和 MP （P=0.002）的三分位，HF 再住院的累积率有显著差异。多变量 Cox 比例风险模型显示，peak VO 的最低三分位数（HR，6.26；95%置信区间（CI），1.93-20.27）和 MP（HR，5.29；95% CI，1.05-26.53）与 HF 再住院相关。股四头肌力量是 HFrEF 患者再住院的独立预测因子。
股四头肌力量是 HFrEF 患者再住院的独立预测因子。
