Impact of Panvascular Disease on Exercise Capacity and Clinical Outcomes in Patients with Heart Failure with Reduced Ejection Fraction

Wang, Qi, Li, Bin, Yu, Fei, Su, Hao, Hu, Kai, Liu, Zhiquan, Wu, Guohong, Yan, Ji, Chen, Tao ORCID: https://orcid.org/0000-0002-5489-6450 and Chen, KangYu (2024) 'Impact of Panvascular Disease on Exercise Capacity and Clinical Outcomes in Patients with Heart Failure with Reduced Ejection Fraction'. CJC Open, Vol 6, Issue 12, pp. 1434-1442.

Preview

Text PIIS2589790X24003809.pdf - Published Version Available under License Creative Commons Attribution Non-commercial No Derivatives. Download (673kB) | Preview

Abstract

Background
The aim of this study was to assess the impact of panvascular disease (PVD) on quality of life (QOL), exercise capacity, and clinical outcomes, in patients with heart failure (HF) with reduced ejection fraction (HFrEF).

Methods
We performed a post hoc analysis of the Heart Failure: A Controlled Trial Investigating Outcomes of Exercise Training (HF-ACTION; NCT00047437). Patients with PVD were defined as those having coronary heart disease, stroke, or peripheral vascular disease at baseline. Multivariable Cox proportional hazard models were constructed to evaluate the effect of PVD on the primary endpoint (all-cause mortality or hospitalization) and secondary endpoints (all-cause mortality, cardiovascular (CV) mortality or CV hospitalization, and CV mortality or HF hospitalization). Generalized estimating-equation models were constructed to evaluate the effect of PVD on QOL (Kansas City Cardiomyopathy Questionnaire score) and exercise capacity (peak oxygen consumption and 6-minute walk test distance).

Results
Of 2119 patients with chronic HFrEF, 1202 (56.7%) had comorbid PVD. PVD was associated significantly with reduced exercise capacity (P < 0.001). Patients with PVD had a higher risk of all-cause mortality or hospitalization (hazard ratio [HR] 1.15, 95% confidence interval [CI]: 1.02-1.29), CV mortality or CV hospitalization (HR 1.22, 95% CI: 1.07-1.39), and CV mortality or HF hospitalization (HR 1.25, 95% CI: 1.05-1.48), compared with the risk for patients without PVD. Aerobic exercise training did not significantly improve the prognosis of HFrEF patients, in either the PVD or the non-PVD subgroups.

Conclusions
PVD may adversely affect the QOL, exercise capacity, and prognosis of patients with chronic HFrEF.

Item Type:	Article
Subjects:	WG Cardiovascular System > WG 120 Cardiovascular diseases
Faculty: Department:	Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI):	https://doi.org/10.1016/j.cjco.2024.08.014
SWORD Depositor:	JISC Pubrouter
Depositing User:	JISC Pubrouter
Date Deposited:	07 Jan 2025 09:04
Last Modified:	07 Jan 2025 09:04
URI:	https://archive.lstmed.ac.uk/id/eprint/25776

Statistics

View details

Actions (login required)

Edit Item