Prognostic Value of Leg Muscle Strength in Acute Heart Failure Syndrome

被引:5
作者
Youn, Jong-Chan [1 ]
Choi, Suk-Won [2 ]
Lee, Hye Sun [3 ]
Han, Seongwoo [2 ]
Shin, Eui-Cheol [4 ]
Baek, Sang Hong [1 ]
Kang, Seok-MIn [5 ]
机构
[1] Catholic Univ Korea, Seoul St Marys Hosp, Div Cardiol, Dept Internal Med,Coll Med, Seoul, South Korea
[2] Hallym Univ, Dongtan Sacred Heart Hosp, Div Cardiol, Hwaseong, South Korea
[3] Yonsei Univ, Biostat Collaborat Unit, Coll Med, Seoul, South Korea
[4] Korea Adv Inst Sci & Technol, Grad Sch Med Sci & Engn, Lab Immunol & Infect Dis, Daejeon, South Korea
[5] Yonsei Univ, Severance Cardiovasc Hosp, Div Cardiol, Coll Med, 50-1 Yonsei Ro, Seoul 03722, South Korea
基金
新加坡国家研究基金会;
关键词
LEG MUSCLE STRENGTH; DYNAMOMETER; INFLAMMATION; ACUTE HEART FAILURE SYNDROME; PROGNOSIS; EXERCISE CAPACITY; VENTILATORY INEFFICIENCY; KSHF GUIDELINES; OLDER PATIENTS; T-CELLS; MANAGEMENT; ABNORMALITIES; INTOLERANCE; MORTALITY; DIAGNOSIS;
D O I
10.1249/MSS.0000000000002432
中图分类号
G8 [体育];
学科分类号
04 ; 0403 ;
摘要
Introduction Leg muscle strength (LMS) may be useful as a frailty index in patients with heart failure. However, LMS, until recently, has been indirectly estimated, and its prognostic value in acute heart failure syndrome (AHFS) is unclear. Therefore, we evaluated the prognostic value of direct LMS assessment and its relationship with proinflammatory mediators in patients with AHFS. Methods We directly measured LMS at predischarge using a dynamometer in 110 prospectively and consecutively enrolled patients with AHFS (75 male; 60 +/- 14 yr; mean ejection fraction, 29.9% +/- 14.6%). The primary end point was cardiovascular (CV) events, defined as CV mortality, cardiac transplantation, or rehospitalization due to heart failure aggravation. Patients were divided into impaired and preserved LMS groups according to Contal and O'Quigley's method. Results CV events occurred in 28 patients (25.5%) (including 5 CV deaths and 6 cardiac transplantations) during follow-up (median, 246 d; range = 11-888 d). Impaired LMS was associated with significantly higher levels of serum monokine induced by gamma interferon and poor clinical outcomes (P < 0.001). Multivariable Cox proportional hazard analysis (controlling for age, sex, body mass index, heart failure type, hemoglobin level, N-terminal pro-b-type natriuretic peptide level, and beta-blocker use) revealed LMS as an independent predictor of CV events (P = 0.017). Conclusion Impaired LMS, which might be used as a marker of frailty, is associated with increased levels of a proinflammatory chemokine and independently predicts clinical outcomes in patients with AHFS. The direct measurement of LMS is simple and feasible and might have important implications for the risk stratification of patients with AHFS.
引用
收藏
页码:19 / 25
页数:7
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