DOI QR코드

DOI QR Code

The Influence of Maximal Aerobic Capacity on the Two Years Cardiac Related Re-Hospitalization in Patients with Heart Failure with Reduced Ejection Fraction in Korean Society

  • Ryu, Ho Youl (Department of Rehabilitation Medical Team, Yong-In Severance Hospital, Yonsei University Health System) ;
  • Hong, Do Sun (Department of Rehabilitation Medical Team, Yong-In Severance Hospital, Yonsei University Health System) ;
  • Kim, Tack Hoon (Department of Physical Therapy, Hanseo University)
  • Received : 2019.09.20
  • Accepted : 2019.10.28
  • Published : 2019.10.31

Abstract

Purpose: This study examined the influence of the maximal aerobic capacity on the two-year cardiac-related re-hospitalization in patients with heart failure with a reduced ejection fraction (HFrEF) in Korean society. Methods: The maximal aerobic capacity of the study population (n=95, male 63%) was evaluated using a cardiopulmonary exercise (CPX) testing system. Each patient was followed up for two years to divide the HFrEF patients into two groups according to cardiac-related re-hospitalization: re-hospitalization (RH) group (n=29, 30%) and no re-hospitalization (NRH) group (n=66, 70%). Results: The relative peak $VO_2$ (mL/kg/min, p<0.001), exercise duration (p<0.001), respiratory exchange ratio ($VCO_2/VO_2$, p=0.001), systolic blood pressure (SBP) reserve (p=0.004), heart rate (HR) reserve (p=0.007), SBP max (p=0.02), and HR max (p=0.039) were significantly lower in the RH group than the NRH group during the CPX test. On the other hand, the ventilatory efficiency (VE/VCO2 slope, p=0.02) and age (p=0.022) were significantly higher in the RH group than in the NRH group. In binary logistic regression analysis, the relative peak $VO_2$ (p=0.001, Wald Chi-square 10.137) was the strongest predictive factor on cardiac-related re-hospitalization, which was followed by $VCO_2/VO_2$ (p=0.019, Wald Chi-square 5.54). On the other hand, age (p=0.063, Wald Chi-square 3.445) did not have a significant influence on cardiac related re-hospitalization. Conclusion: The maximal aerobic capacity, especially the relative peak $VO_2$, is the strongest factor on cardiac-related re-hospitalization within two years in patients with HFrEF in Korean society.

Keywords

References

  1. Dickstein K, Cohen-Solal A, Filipppatos G et al. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2008: the Task Force for the diagnosis and treatment of acute and chronic heart failure 2008 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association of the ESC (HFA) and endorsed by the European Society of Intensive Care Medicine (ESICM). Eur J Heart Fail. 2008;10(10):933-89. https://doi.org/10.1016/j.ejheart.2008.08.005
  2. Chase P, Arena R, Myers J et al. Prognostic usefulness of dyspnea versus fatigue as reason for exercise test termination in patients with heart failure. Am J Cardiol. 2008;102(7):879-82. https://doi.org/10.1016/j.amjcard.2008.05.031
  3. Anker SD, Chua TP, Ponikowski P et al. Hormonal changes and catabolic/anabolic imbalance in chronic heart failure and their importance for cardiac cachexia. Circulation. 1997;96:526-34. https://doi.org/10.1161/01.CIR.96.2.526
  4. Burns RB, McCarthy EP, Moskowitz MA et al. Outcomes for older men and women with congestive heart failure. J AM Geriatr Soc. 1997;45:276-80. https://doi.org/10.1111/j.1532-5415.1997.tb00940.x
  5. Miller MS, Vanburen P, Lewinter MM et al. Mechanisms underlying skeletal muscle weakness in human heart failure: alterations in single fiber myosin protein content and function. Heart Fail. 2009;2:700-6. https://doi.org/10.1161/CIRCHEARTFAILURE.109.876433
  6. Sagar VA, Davies EJ, Briscoe S et al. Exercise-based rehabilitation for heart failure: systematic review and meta-analysis. Open Heart. 2015;2(1): e000163. https://doi.org/10.1136/openhrt-2014-000163
  7. Keteyian SJ, Patel M, Kraus WE et al. Variables measured during cardiopulmonary exercise testing as predictors of mortality in chronic systolic heart failure. J Am Coll Cardiol. 2016;67(7):780-9. https://doi.org/10.1016/j.jacc.2015.11.050
  8. Choi HJ, Kang SM, Youn JC et al. Cheonical herat failure: 16 thins chaged, The Korean Society of Hear Failur. 2016.
  9. Rusnak J, Behnes M, Schupp T, et al. Comparable survival in ischemic and nonischemic cardiomyopathy secondary to ventricular tachyarrhy-thmias and aborted cardiac arrest. Coronary Artery Disease. 2019;30-4:303-11. https://doi.org/10.1097/MCA.0000000000000738
  10. Muller J, Behnes M, Ellguth D et al. Prognostic impact of left ventricular ejection fraction in patients with electrical storm. J Interv Card Electrophysiol. 2019;55:307-15. https://doi.org/10.1007/s10840-019-00525-y
  11. Corra U, Giordano A, Mezzani A, et al. Cardiopulmonary exercise testing and prognosis in heart failure due to systolic left ventricular dysfunction: a validation study of the European Society of Cardiology Guidelines and Recommendations (2008) and further developments. Eur J Prev Cardiol. 2012;19:32-40. https://doi.org/10.1177/1741826710393994
  12. Mancini DM, Mancini DM, Eisen H et al. Value of peak exercise oxygen consumption for optimal timing of cardiac transplantation in ambulatory patients with heart failure. Circulation. 1991;83:778-86. https://doi.org/10.1161/01.CIR.83.3.778
  13. Fletcher GF, Ades PA, Kligfield P et al Exercise standards for testing and training: A scientific statement from the american heart association. Circulation. 2013;128:873-934. https://doi.org/10.1161/CIR.0b013e31829b5b44
  14. Kaminsky LA, Bonzheim KA, Garber CE et al. ACSM's resource manual for guidelines for exercise testing and prescription. 5th edition. Philadelphia, Lippincott Williams & Wilkins. 2008.
  15. Youn JC, Lee HS, Choi SW et al. Post-exercise heart rate recovery independently predicts clinical outcome in patients with acute decompensated heart failure. PLoS One. 2016;11(5):e0154534. https://doi.org/10.1371/journal.pone.0154534
  16. Ryu HY, Kim KS, Jeon IC. Influence of home based exercise intensity on the aerobic capacity and 1 Year re-hospitalization rate in patients with chronic heart failure. J Kor Phys Ther. 2018;30:181-6. https://doi.org/10.18857/jkpt.2018.30.5.181

Cited by

  1. Use of the Talk Test for Comparison of Exercise Intensity between Aerobic Activities with Treadmill and Bicycle vol.32, pp.2, 2019, https://doi.org/10.18857/jkpt.2020.32.2.132