HF rehospitalization risk linked to knee extensor muscle power
Patients who experienced HF rehospitalization presented with lower values for skeletal muscle fitness parameters and knee extensor muscle power compared with patients with HF who were not rehospitalized, according to study results.
“The loss of muscle mass and strength occurs progressively with aging. Irrespective of aging, chronic diseases accelerate the atrophy of muscle fibers or lower the efficiency of energy production in the muscles, leading to low levels of muscular fitness, which is also associated with poor prognosis,” Chan Joo Lee, MD, PhD, of the division of cardiology at Severance Cardiovascular Hospital, Yonsei University College of Medicine in Seoul, South Korea, and colleagues wrote. “In patients with HF, muscular strength predicts long-term survival. However, the effect of muscle fitness on rehospitalization has not been fully investigated.”
To investigate the predictive potential of knee extensor muscle strength and power on rehospitalization in patients with HF, researchers analyzed 99 patients (mean age, 59 years, 66% men) hospitalized with a new diagnosis of HF. Researchers measured aerobic exercise capacity, knee extensor maximal voluntary isometric contraction (MVIC) and muscle power during a mean follow-up of 1,691 days.
Researchers found 39.4% of patients experienced rehospitalization due to HF aggravation during the follow-up period. There were higher rehospitalization rates in patients with diabetes and in patients with lower oxygen levels at peak exercise (21.6 oxygen uptake [VO2] vs. 17.7 VO2; P < .001), knee extensor MVIC (399.6 N vs. 332.9 N; P = .018) and muscle power (145.7 W vs.116.2 W; P = .052). Further multivariable Cox proportional hazard models showed the lowest tertiles of peak VO2 (HR = 6.26; 95% CI, 1.93-20.27) and muscle power (HR = 5.29; 95% CI, 1.05-26.53) were associated with HF rehospitalization; Kaplan-Meier survival analysis found different cumulative HF rehospitalization rates according to the tertiles of peak VO2 (P = .005) and muscle power (P = .002).
“Aerobic exercise capacity and muscle fitness were associated with the prognosis of patients with HF with reduced ejection fraction,” Lee and colleagues wrote. “Compared with MVIC, which is the traditional method of measuring knee extensor fitness, measurement of muscle power was found to be a better predictor for HF rehospitalization in these patients.”
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