Cargando…
Higher cardiorespiratory fitness predicts long-term survival in patients with heart failure and preserved ejection fraction: the Henry Ford Exercise Testing (FIT) Project
INTRODUCTION: Higher 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 det...
Autores principales: | , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Termedia Publishing House
2019
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6425214/ https://www.ncbi.nlm.nih.gov/pubmed/30899287 http://dx.doi.org/10.5114/aoms.2019.83290 |
_version_ | 1783404799617662976 |
---|---|
author | Orimoloye, Olusola A. Kambhampati, Swetha Hicks, Albert J. Al Rifai, Mahmoud Silverman, Michael G. Whelton, Seamus Qureshi, Waqas Ehrman, Jonathan K. Keteyian, Steven J. Brawner, Clinton A. Dardari, Zeina Al-Mallah, Mouaz H. Blaha, Michael J. |
author_facet | Orimoloye, Olusola A. Kambhampati, Swetha Hicks, Albert J. Al Rifai, Mahmoud Silverman, Michael G. Whelton, Seamus Qureshi, Waqas Ehrman, Jonathan K. Keteyian, Steven J. Brawner, Clinton A. Dardari, Zeina Al-Mallah, Mouaz H. Blaha, Michael J. |
author_sort | Orimoloye, Olusola A. |
collection | PubMed |
description | INTRODUCTION: Higher 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 METHODS: In 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. RESULTS: Mean 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. CONCLUSIONS: Moderate-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. |
format | Online Article Text |
id | pubmed-6425214 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Termedia Publishing House |
record_format | MEDLINE/PubMed |
spelling | pubmed-64252142019-03-21 Higher cardiorespiratory fitness predicts long-term survival in patients with heart failure and preserved ejection fraction: the Henry Ford Exercise Testing (FIT) Project Orimoloye, Olusola A. Kambhampati, Swetha Hicks, Albert J. Al Rifai, Mahmoud Silverman, Michael G. Whelton, Seamus Qureshi, Waqas Ehrman, Jonathan K. Keteyian, Steven J. Brawner, Clinton A. Dardari, Zeina Al-Mallah, Mouaz H. Blaha, Michael J. Arch Med Sci Clinical Research INTRODUCTION: Higher 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 METHODS: In 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. RESULTS: Mean 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. CONCLUSIONS: Moderate-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. Termedia Publishing House 2019-03-04 2019-03 /pmc/articles/PMC6425214/ /pubmed/30899287 http://dx.doi.org/10.5114/aoms.2019.83290 Text en Copyright: © 2019 Termedia & Banach http://creativecommons.org/licenses/by-nc-sa/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license. |
spellingShingle | Clinical Research Orimoloye, Olusola A. Kambhampati, Swetha Hicks, Albert J. Al Rifai, Mahmoud Silverman, Michael G. Whelton, Seamus Qureshi, Waqas Ehrman, Jonathan K. Keteyian, Steven J. Brawner, Clinton A. Dardari, Zeina Al-Mallah, Mouaz H. Blaha, Michael J. Higher cardiorespiratory fitness predicts long-term survival in patients with heart failure and preserved ejection fraction: the Henry Ford Exercise Testing (FIT) Project |
title | Higher cardiorespiratory fitness predicts long-term survival in patients with heart failure and preserved ejection fraction: the Henry Ford Exercise Testing (FIT) Project |
title_full | Higher cardiorespiratory fitness predicts long-term survival in patients with heart failure and preserved ejection fraction: the Henry Ford Exercise Testing (FIT) Project |
title_fullStr | Higher cardiorespiratory fitness predicts long-term survival in patients with heart failure and preserved ejection fraction: the Henry Ford Exercise Testing (FIT) Project |
title_full_unstemmed | Higher cardiorespiratory fitness predicts long-term survival in patients with heart failure and preserved ejection fraction: the Henry Ford Exercise Testing (FIT) Project |
title_short | Higher cardiorespiratory fitness predicts long-term survival in patients with heart failure and preserved ejection fraction: the Henry Ford Exercise Testing (FIT) Project |
title_sort | higher cardiorespiratory fitness predicts long-term survival in patients with heart failure and preserved ejection fraction: the henry ford exercise testing (fit) project |
topic | Clinical Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6425214/ https://www.ncbi.nlm.nih.gov/pubmed/30899287 http://dx.doi.org/10.5114/aoms.2019.83290 |
work_keys_str_mv | AT orimoloyeolusolaa highercardiorespiratoryfitnesspredictslongtermsurvivalinpatientswithheartfailureandpreservedejectionfractionthehenryfordexercisetestingfitproject AT kambhampatiswetha highercardiorespiratoryfitnesspredictslongtermsurvivalinpatientswithheartfailureandpreservedejectionfractionthehenryfordexercisetestingfitproject AT hicksalbertj highercardiorespiratoryfitnesspredictslongtermsurvivalinpatientswithheartfailureandpreservedejectionfractionthehenryfordexercisetestingfitproject AT alrifaimahmoud highercardiorespiratoryfitnesspredictslongtermsurvivalinpatientswithheartfailureandpreservedejectionfractionthehenryfordexercisetestingfitproject AT silvermanmichaelg highercardiorespiratoryfitnesspredictslongtermsurvivalinpatientswithheartfailureandpreservedejectionfractionthehenryfordexercisetestingfitproject AT wheltonseamus highercardiorespiratoryfitnesspredictslongtermsurvivalinpatientswithheartfailureandpreservedejectionfractionthehenryfordexercisetestingfitproject AT qureshiwaqas highercardiorespiratoryfitnesspredictslongtermsurvivalinpatientswithheartfailureandpreservedejectionfractionthehenryfordexercisetestingfitproject AT ehrmanjonathank highercardiorespiratoryfitnesspredictslongtermsurvivalinpatientswithheartfailureandpreservedejectionfractionthehenryfordexercisetestingfitproject AT keteyianstevenj highercardiorespiratoryfitnesspredictslongtermsurvivalinpatientswithheartfailureandpreservedejectionfractionthehenryfordexercisetestingfitproject AT brawnerclintona highercardiorespiratoryfitnesspredictslongtermsurvivalinpatientswithheartfailureandpreservedejectionfractionthehenryfordexercisetestingfitproject AT dardarizeina highercardiorespiratoryfitnesspredictslongtermsurvivalinpatientswithheartfailureandpreservedejectionfractionthehenryfordexercisetestingfitproject AT almallahmouazh highercardiorespiratoryfitnesspredictslongtermsurvivalinpatientswithheartfailureandpreservedejectionfractionthehenryfordexercisetestingfitproject AT blahamichaelj highercardiorespiratoryfitnesspredictslongtermsurvivalinpatientswithheartfailureandpreservedejectionfractionthehenryfordexercisetestingfitproject |