Open AccessAssociation of muscular fitness with rehospitalization for heart failure with reduced ejection fraction
Author(s) -
Lee Chan Joo,
Ryu Ho Youl,
Chun KyeongHyeon,
Oh Jaewon,
Park Sungha,
Lee SangHak,
Kang SeokMin
Publication year - 2021
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.23535
Subject(s) - medicine , ejection fraction , heart failure , hazard ratio , cardiology , isometric exercise , confidence interval , proportional hazards model , anaerobic exercise , vo2 max , exacerbation , physical therapy , heart rate , blood pressure
Background Limited information is available regarding the prognostic potential of muscular fitness parameters in heart failure (HF) with reduced ejection fraction (HFrEF). Hypothesis 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. Methods 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. Results 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 2 ), knee extensor MVIC, and MP. The Kaplan–Meier survival analysis revealed significantly different cumulative HF rehospitalization rates according to the tertiles of peak VO 2 ( P = 0.005) and MP ( P = 0.002). Multivariable Cox proportional hazard model showed that the lowest tertiles of peak VO 2 (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. Conclusion Knee extensor muscle power was an independent predictor for rehospitalization in patients with HFrEF.