Self-reported engagement in exercise is associated with longer event-free survival in heart failure patients with poor functional capacity.
Self-reported engagement in exercise is associated with longer event-free survival in heart failure patients with poor functional capacity.
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自我报告的运动参与与功能能力较差的心力衰竭患者的较长无事件生存期相关。
DOI：
10.1093/eurjcn/zvac044
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发表时间：
2023
影响因子：
2.9
通讯作者：
Lennie,TerryA
中科院分区：
文献类型：
--
作者：
Madujibeya,Ifeanyi;Chung,MisookL;Moser,DebraK;Miller,JenniferA;Lennie,TerryA
目的尽管有证据支持临床稳定的心力衰竭（HF）患者进行无监督运动，但与HF结局改善相关的每周最小累积运动剂量，特别是在功能能力差的患者中，尚未进行检查。我们研究了是否与HF和功能差的能力，报告在指南推荐的每周最低限度的运动参与的患者有较长的无事件生存期比patients who doesn 't exercise.Methods and resultsThis analysis包括310例HF患者谁已经完成了杜克活动状态指数（DASI），并报告他们的参与程度在运动。使用DASI临界点≥19将患者分为良好和较差的功能能力，然后根据他们自我报告的运动水平进一步分层：高（≥60分钟/周）和低（<60分钟/周）。校正协变量后，使用考克斯回归模型预测四组的无事件生存期。患者（平均年龄= 61.6 ± 11.4岁，30.3%为女性，44.2%为NYHA III-IV级）的中位随访时间为362天。有8人死亡，108人因各种原因住院。与报告运动参与度低的功能能力差患者相比，报告运动参与度高的功能能力差患者的全因住院或死亡风险降低36（风险比：结论自我报告的每周至少60分钟的运动与无事件生存率的显著改善相关，即使是在功能能力低的HF患者中。这些结果提供了证据表明，这种运动量对HF和功能能力差的患者有益。
AimsDespite evidence-based recommendations for clinically stable patients with heart failure (HF) to engage in unsupervised exercise, the minimum cumulative dose of exercise per week associated with improvement in HF outcomes, especially in patients with poor functional capacity, has not been examined. We examined whether patients with HF and poor functional capacity who reported engagement in a guideline-recommended minimum weekly exercise had longer event-free survival than patients who did not exercise.Methods and resultsThis analysis included 310 patients with HF who had completed the Duke Activity Status Index (DASI) and reported their level of engagement in exercise. Patients were grouped into good and poor functional capacity using a DASI cut-point of ≥19 and then further stratified based on their self-reported exercise level: high (≥60 min/week) and low (<60 min/week). Cox regression modelling was used to predict event-free survival for the four groups after adjusting for covariates. Patients (mean age = 61.6 ± 11.4 years, 30.3% female, 44.2% NYHA Classes III–IV) were followed for a median of 362 days. There were eight deaths and 108 all-cause hospitalizations. Patients with poor functional capacity who reported high exercise engagement had a 36% lower risk of all-cause hospitalization or mortality compared with patients with poor functional capacity who reported low exercise engagement (hazard ratio: 0.64,P= 0.028).ConclusionSelf-reported engagement in a minimum of 60 min of exercise per week was associated with a significant improvement in event-free survival, even in patients with HF with low functional capacity. These results provide evidence that this dose of exercise is beneficial in patients with HF and poor functional capacity.
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