Improvement of exercise tolerance in cardiopulmonary testing with sustained safety after regular training in outpatients with systolic heart failure (NYHA III) and an implantable cardioverter-defibrillator. Prospective 18-month randomized study

Smolis−Bąk, Edyta; Rymuza, Hanna; Kazimierska, Barbara; Kowalik, Ilona; Chwyczko, Tomasz; Borowiec, Anna; Rongies, Witold; Jankowska, Agnieszka; Szwed, Hanna; Dąbrowski, Rafał

doi:10.5114/aoms.2016.61938

Cited by 11 publications

(7 citation statements)

References 21 publications

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“…Overall, in the absence of effective pharmacologic treatments available for patients with HFpEF, regular exercise training has shown strong objective evidence in improving quality of life and functional capacity for patients with HFpEF [ 31 , 32 ]. This study therefore sheds light on improved mortality over long-term follow-up with CRF in patients with HFpEF, which has not been sufficiently demonstrated in the existing literature.…”

Section: Discussionmentioning

confidence: 99%

Higher cardiorespiratory fitness predicts long-term survival in patients with heart failure and preserved ejection fraction: the Henry Ford Exercise Testing (FIT) Project

Orimoloye

Kambhampati

Hicks

et al. 2019

aoms

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IntroductionHigher cardiorespiratory fitness (CRF) is associated with improved exercise capacity and quality of life in heart failure with preserved ejection fraction (HFpEF), but there are no large studies evaluating the association of HFpEF, CRF, and long-term survival. We therefore aimed to determine the association between CRF and all-cause mortality, in patients with HFpEF.Material and methodsIn the Henry Ford Exercise Testing (FIT) Project, 167 patients had baseline HFpEF, defined as a clinical diagnosis of heart failure with ejection fraction ≥ 50% on echocardiogram. The CRF was estimated from the peak workload (in METs) from a clinician-referred treadmill stress test and categorized as poor (1–4 METs), intermediate (5–6 METs), and moderate-high (≥ 7 METs). Additional analyses assessing the effect of HFpEF and CRF on mortality were also conducted, matching HFpEF patients to non-HFpEF patients using propensity scores.ResultsMean age was 64 ±13 years, with 55% women, and 46% Black. Over a median follow-up of 9.7 (5.2–18.9) years, there were 103 deaths. In fully adjusted models, moderate-high CRF was associated with 63% lower mortality risk (HR = 0.37, 95% CI: 0.18–0.73) compared to the poor-CRF group. In the propensity-matched cohort, HFpEF was associated with a HR of 2.3 (95% CI: 1.7–3.2) for mortality compared to non-HFpEF patients, which was attenuated to 1.8 (95% CI: 1.3–2.5) after adjusting for CRF.ConclusionsModerate-high CRF in patients with HFpEF is associated with improved survival, and differences in CRF partly explain the intrinsic risk of HFpEF. Randomized trials of interventions aimed at improving CRF in HFpEF are needed.

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Section: Discussionmentioning

confidence: 99%

Higher cardiorespiratory fitness predicts long-term survival in patients with heart failure and preserved ejection fraction: the Henry Ford Exercise Testing (FIT) Project

Orimoloye

Kambhampati

Hicks

et al. 2019

aoms

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“…However, it has also been suggested that the presence of a hospice medical director and standing orders may also contribute to the lower risk of readmission. Future randomized controlled trials need to examine whether these and other strategies such as improving physical activity and mobility incorporated into the home health services program would improve outcomes, thus providing evidence of cost effectiveness of a program that often allows hospitalized frail patients to go home [ 31 , 32 ].…”

Section: Discussionmentioning

confidence: 99%

Discharge home health services referral and 30-day all-cause readmission in older adults with heart failure

Arundel¹,

Sheriff²,

Bearden³

et al. 2018

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IntroductionHeart failure (HF) is the leading cause of hospital readmission. Medicare home health services provide intermittent skilled nursing care to homebound Medicare beneficiaries. We examined whether discharge home health referral is associated with a lower risk of 30-day all-cause readmission in HF.Material and methodsOf the 8049 Medicare beneficiaries hospitalized for acute HF and discharged alive from 106 Alabama hospitals, 6406 (76%) patients were not admitted from nursing homes and were discharged home without discharge hospice referrals. Of these, 1369 (21%) received a discharge home health referral. Using propensity scores for home health referral, we assembled a matched cohort of 1253 pairs of patients receiving and not receiving home health referrals, balanced on 33 baseline characteristics.ResultsThe 2506 matched patients had a mean age of 78 years, 61% were women, and 27% were African American. Thirty-day all-cause readmission occurred in 28% and 19% of matched patients receiving and not receiving home health referrals, respectively (hazard ratio (HR) = 1.52; 95% confidence interval (CI): 1.29–1.80; p < 0.001). Home health referral was also associated with a higher risk of 30-day all-cause mortality (HR = 2.32; 95% CI: 1.58–3.41; p < 0.001) but not with 30-day HF readmission (HR = 1.28; 95% CI: 0.99–1.64; p = 0.056). HRs (95% CIs) for 1-year all-cause readmission, all-cause mortality, and HF readmission are 1.24 (1.13–1.36; p < 0.001), 1.37 (1.20–1.57; p < 0.001) and 1.09 (0.95–1.24; p = 0.216), respectively.ConclusionsHospitalized HF patients who received discharge home health services referral had a higher risk of 30-day and 1-year all-cause readmission and all-cause mortality, but not of HF readmission.

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“…Cardiopulmonary exercise testing (CPX) is a useful way to evaluate prognosis, risk of metabolic diseases, condition of diseases, determination of exercise intensity, and efficacy of exercise therapy [1][2][3][4][5] . The most popular marker is peak oxygen uptake (VO 2 ).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of oxygen uptake adjusted by skeletal muscle mass in cardiovascular disease patients with type 2 diabetes

et al. 2021

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We aimed to evaluate oxygen uptake adjusted by total skeletal muscle mass in patients with cardiovascular disease with or without type 2 diabetes mellitus. [Participants and Methods] The participants included 54 males ≥50 years of age without heart failure who underwent cardiopulmonary exercise testing during cardiac rehabilitation. We divided the participants into two groups: patients with type 2 diabetes mellitus (DM group) and patients without type 2 diabetes mellitus (NDM group). [Results] We found no significant differences in age, weight, fat mass, or skeletal muscle mass between the groups. There were also no differences in cardiac function, body composition, and heart rate response. The DM group showed significantly lower peak oxygen uptake values adjusted by skeletal muscle mass, despite the absence of significant differences in skeletal muscle mass. A significant positive correlation was found between peak oxygen uptake and age, weight, and skeletal muscle mass. Stepwise regression analysis revealed that age, skeletal muscle mass, and medical history of diabetes were independent predictors of absolute peak oxygen uptake. [Conclusion] Peak oxygen uptake adjusted by skeletal muscle mass in patients with cardiovascular disease and type 2 diabetes mellitus is lower than that in those without type 2 diabetes mellitus.

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Improvement of exercise tolerance in cardiopulmonary testing with sustained safety after regular training in outpatients with systolic heart failure (NYHA III) and an implantable cardioverter-defibrillator. Prospective 18-month randomized study

Cited by 11 publications

References 21 publications

Higher cardiorespiratory fitness predicts long-term survival in patients with heart failure and preserved ejection fraction: the Henry Ford Exercise Testing (FIT) Project

Higher cardiorespiratory fitness predicts long-term survival in patients with heart failure and preserved ejection fraction: the Henry Ford Exercise Testing (FIT) Project

Discharge home health services referral and 30-day all-cause readmission in older adults with heart failure

Evaluation of oxygen uptake adjusted by skeletal muscle mass in cardiovascular disease patients with type 2 diabetes

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