Department of Rehabilitation, Sakura Medical Center, Toho University.
Faculty of Social Work Studies Department of Physical Therapy, Josai International University.
Int Heart J. 2024;65(5):866-872. doi: 10.1536/ihj.24-378.
Balance dysfunction in older patients compromises independence and increases the risk of falls and disability. Arterial stiffness, an important parameter of atherosclerosis, can affect peripheral organs, including the brain, causing balance disorders. The cardio-ankle vascular index (CAVI), measured independently of blood pressure, has attracted attention as an indicator of arterial stiffness. However, the association between balance dysfunction and CAVI in patients with heart failure remains unclear. We investigated the association between the Short Physical Performance Battery (SPPB) score and CAVI in older patients with heart failure.We investigated heart failure patients from our cardiac rehabilitation database between 2017 and 2022. Physical function, body composition, and CAVI were measured the day before discharge. Body composition was assessed using bioelectrical impedance analysis. Physical function was determined by assessing handgrip strength, 6-minute walk distance, and SPPB. Sarcopenia was classified according to the Asian Working Group for Sarcopenia 2019 guidelines, defining sarcopenia as an SPPB total score ≤ 9.Among the 205 consecutive hospitalized patients aged ≥ 65 years (mean, 77.0 years; male, 140; female, 65), 45.0% had sarcopenia. CAVI was significantly higher in patients with sarcopenia than in those without (10.4 [9.5, 11.4] versus 9.8 [8.9, 10.8], respectively). Age, 6-minute walk distance, SPPB tandem time, 4-m walk time, 5 repetition sit-to-stand time, and SPPB score were significantly associated with CAVI, with tandem being an independent CAVI determinant (β = -0.142, P = 0.047).These results suggest an association between arterial stiffness and SPPB score in older patients with heart failure.
平衡功能障碍会影响老年人的独立性，增加跌倒和残疾的风险。动脉僵硬度是动脉粥样硬化的一个重要参数，它可以影响包括大脑在内的外周器官，导致平衡障碍。心血管脚踝血管指数（CAVI）是一种独立于血压测量的动脉僵硬度指标，已引起关注。然而，心力衰竭患者的平衡功能障碍与 CAVI 之间的关系尚不清楚。我们研究了心力衰竭老年患者的短体适能表现测试（SPPB）评分与 CAVI 之间的关系。我们从 2017 年至 2022 年的心脏康复数据库中调查了心力衰竭患者。在出院前一天测量身体功能、身体成分和 CAVI。身体成分使用生物电阻抗分析进行评估。身体功能通过评估握力、6 分钟步行距离和 SPPB 来确定。根据 2019 年亚洲肌肉减少症工作组的指南对肌肉减少症进行分类，将 SPPB 总分≤9 定义为肌肉减少症。在 205 名连续住院的≥65 岁（平均 77.0 岁；男性 140 名；女性 65 名）患者中，45.0%患有肌肉减少症。与无肌肉减少症的患者相比，有肌肉减少症的患者 CAVI 明显更高（分别为 10.4[9.5, 11.4]与 9.8[8.9, 10.8]）。年龄、6 分钟步行距离、SPPB 并足时间、4 米步行时间、5 次重复坐站时间和 SPPB 评分与 CAVI 显著相关，其中并足是 CAVI 的独立决定因素（β=-0.142，P=0.047）。这些结果表明，心力衰竭老年患者的动脉僵硬度与 SPPB 评分之间存在关联。
