Department of Rehabilitation, Kitasato University Hospital, 1-15-1 Kitasato, Minami-ku, Sagamihara 252-0375, Japan.
Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara 252-0373, Japan.
Eur J Cardiovasc Nurs. 2022 Nov 23;21(8):782-790. doi: 10.1093/eurjcn/zvac014.
Although the developmental mechanism of respiratory muscle weakness (RMW) and frailty are partly similar in patients with cardiovascular disease (CVD), their relationship remains unclear. This study aimed to investigate the correlation between RMW and frailty and its impact on clinical outcomes in patients with CVD.
In this retrospective observational study, consecutive 1217 patients who were hospitalized for CVD treatment were enrolled. We assessed frailty status by using the Fried criteria and respiratory muscle strength by measuring the maximal inspiratory pressure (PImax) at hospital discharge, with RMW defined as PImax <70% of the predicted value. The endpoint was a composite of all-cause death and/or readmission for heart failure. We examined the prevalence of RMW and frailty and their correlation. The relationships of RMW with the endpoint for each presence or absence of frailty were also investigated. Respiratory muscle weakness and frailty were observed in 456 (37.5%) and 295 (24.2%) patients, respectively, and 149 (12.2%) patients had both statuses. Frailty was detected as a significant indicator of RMW [odds ratio: 1.84, 95% confidence interval (CI): 1.39-2.44]. Composite events occurred in 282 patients (23.2%). Respiratory muscle weakness was independently associated with an increased incidence of events in patients with both non-frailty [hazard ratio (HR): 1.40, 95% CI: 1.04-1.88] and frailty (HR: 1.68, 95% CI: 1.07-2.63).
This is the first to demonstrate a correlation between RMW and frailty in patients with CVD, with 12.2% of patients showing overlap. RMW was significantly associated with an increased risk of poor outcomes in patients with CVD and frailty.
尽管心血管疾病（CVD）患者的呼吸肌无力（RMW）和虚弱的发展机制部分相似，但它们之间的关系尚不清楚。本研究旨在探讨 RMW 与虚弱之间的相关性及其对 CVD 患者临床结局的影响。
在这项回顾性观察性研究中，连续纳入了 1217 名因 CVD 住院治疗的患者。我们使用 Fried 标准评估虚弱状态，并在出院时测量最大吸气压力（PImax）来评估呼吸肌强度，将 PImax<70%预测值定义为 RMW。终点是全因死亡和/或心力衰竭再入院的复合终点。我们检查了 RMW 和虚弱的发生率及其相关性。还研究了 RMW 与每种虚弱状态存在或不存在时的终点之间的关系。分别有 456 例（37.5%）和 295 例（24.2%）患者存在 RMW 和虚弱，149 例（12.2%）患者同时存在这两种情况。虚弱被确定为 RMW 的显著指标[优势比：1.84，95%置信区间（CI）：1.39-2.44]。282 例患者（23.2%）发生复合事件。在非虚弱[风险比（HR）：1.40，95%CI：1.04-1.88]和虚弱[HR：1.68，95%CI：1.07-2.63]患者中，RMW 与事件发生率增加独立相关。
这是首次证明 CVD 患者的 RMW 与虚弱之间存在相关性，其中 12.2%的患者存在重叠。RMW 与 CVD 和虚弱患者不良结局风险增加显著相关。
