Department of Cardiovascular Medicine, Yokosuka City Hospital, Yokosuka, Japan; Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan; Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan.
Exp Gerontol. 2021 Dec;156:111626. doi: 10.1016/j.exger.2021.111626. Epub 2021 Nov 13.
Low physical performance may contribute to reduced exercise capacity in older patients with heart failure (HF). We sought to identify the determinants of exercise capacity out of a plethora of background factors, including measures of physical performance.
We performed a post-hoc analysis of a cohort study that included 1205 consecutive older (age ≥ 65 years) hospitalized patients (the median age, 80 years; 57.4% males).
Low physical performance, defined as ≤1.0 m/s for gait speed, ≥12 s for the 5-time chair stand test, or ≤ 9 points for the Short Physical Performance Battery in both sexes, was seen in 83.9% of the cohort. Multivariate regression analysis revealed that each parameter of physical performance (i.e., gait speed, chair stand test, and balance test) was identified as an independent determinant of lower exercise capacity assessed using the 6-min walking distance. In a logistic regression model, low physical performance predicted short (<300 m) 6-min walking distance (adjusted odds ratio 10.28, 95% CI 6.01-17.60, p < 0.001). No interaction was detected between patients with preserved and reduced ejection fraction.
Low physical performance was prevalent and independently associated with exercise capacity in older patients with HF, irrespective of preserved or reduced ejection fraction.
低身体表现可能导致老年心力衰竭（HF）患者的运动能力下降。我们试图从众多背景因素中确定运动能力的决定因素，包括身体表现的测量。
我们对一项队列研究进行了事后分析，该研究纳入了 1205 例连续的老年（年龄≥65 岁）住院患者（中位数年龄 80 岁；57.4%为男性）。
在该队列中，83.9%的患者表现出低身体表现，定义为两性的步态速度≤1.0m/s、5 次椅子站立测试≥12s 或短体性能电池≤9 分。多变量回归分析显示，身体表现的每个参数（即步态速度、椅子站立测试和平衡测试）均被确定为使用 6 分钟步行距离评估的较低运动能力的独立决定因素。在逻辑回归模型中，低身体表现预测 6 分钟步行距离较短（<300m）（调整后的优势比 10.28，95%CI 6.01-17.60，p<0.001）。在射血分数保留和降低的患者之间未检测到交互作用。
无论射血分数是否保留或降低，低身体表现与老年 HF 患者的运动能力独立相关，且较为普遍。
