Incremental Value of Gait Speed in Predicting Prognosis of Older Adults With Heart Failure Insights From the IMAGE-HF Study
Incremental Value of Gait Speed in Predicting Prognosis of Older Adults With Heart Failure Insights From the IMAGE-HF Study
复制标题
DOI：
10.1016/j.jchf.2015.12.017
复制
发表时间：
2016-04-01
影响因子：
13
通讯作者：
Uguccioni, Massimo
中科院分区：
文献类型：
--
作者：
Pulignano, Giovanni;Del Sindaco, Donatella;Uguccioni, Massimo
本研究的目的是评估步态速度与老年心力衰竭（HF）患者死亡和/或住院风险之间的关系。背景步态速度是老年人虚弱的可靠单一标志物，可以预测福尔斯、残疾、住院和死亡率。331例≥ 70岁的社区生活患者（平均年龄78 ± 6岁，43%为女性，平均射血分数35 ± 11%，平均纽约心脏协会功能分级2.7 +/- 0.6）前瞻性入组病情稳定并接受慢性HF优化治疗的患者，并随访1年。以超过4 m的常规步速测量步态速度，以三分位数：= 0.99和m/s定义截止值。结果步态速度三分位数与1年死亡率之间存在显著相关性：分别为38.3%、21.9%和9.1%（p < 0.001）。在多变量分析中，步态速度与全因死亡风险降低相关（风险比：0.62; 95%置信区间：0.43 - 0.88），与年龄、射血分数、
OBJECTIVES The aim of this study was to assess the relationship between gait speed and the risk for death and/or hospital admission in older patients with heart failure (HF).BACKGROUND Gait speed is a reliable single marker of frailty in older people and can predict falls, disability, hospital admissions, and mortality.METHODS In total, 331 community-living patients >= 70 years of age (mean age 78 +/- 6 years, 43% women, mean ejection fraction 35 +/- 11%, mean New York Heart Association functional class 2.7 +/- 0.6) in stable condition and receiving optimized therapy for chronic HF were prospectively enrolled and followed for 1 year. Gait speed was measured at the usual pace over 4 m, and cutoffs were defined by tertiles: = 0.99, and m/s.RESULTS There was a significant association between gait speed tertiles and 1-year mortality: 38.3%, 21.9%, and 9.1% (p < 0.001), respectively. On multivariate analysis, gait speed was associated with a lower risk for all-cause death (hazard ratio: 0.62; 95% confidence interval: 0.43 to 0.88) independently of age, ejection fraction