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

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 dete...

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Autores principales: Olusola A. Orimoloye, Swetha Kambhampati, Albert J. Hicks III, Mahmoud Al Rifai, Michael G. Silverman, Seamus Whelton, Waqas Qureshi, Jonathan K. Ehrman, Steven J. Keteyian, Clinton A. Brawner, Zeina Dardari, Mouaz H. Al-Mallah, Michael J. Blaha
Formato: article
Lenguaje:EN
Publicado: Termedia Publishing House 2019
Materias:
heart failure
risk assessment
cardiovascular disease
risk prediction
Medicine
R
Acceso en línea:https://doaj.org/article/5c18893c77e04e52b674852786bb79ef
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spelling oai:doaj.org-article:5c18893c77e04e52b674852786bb79ef2021-12-02T16:59:25ZHigher cardiorespiratory fitness predicts long-term survival in patients with heart failure and preserved ejection fraction: the Henry Ford Exercise Testing (FIT) Project1734-19221896-915110.5114/aoms.2019.83290https://doaj.org/article/5c18893c77e04e52b674852786bb79ef2019-03-01T00:00:00Zhttps://www.archivesofmedicalscience.com/Higher-cardiorespiratory-fitness-predicts-long-term-survival-in-patients-with-heart,86486,0,2.htmlhttps://doaj.org/toc/1734-1922https://doaj.org/toc/1896-9151Introduction 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.Olusola A. OrimoloyeSwetha KambhampatiAlbert J. Hicks IIIMahmoud Al RifaiMichael G. SilvermanSeamus WheltonWaqas QureshiJonathan K. EhrmanSteven J. KeteyianClinton A. BrawnerZeina DardariMouaz H. Al-MallahMichael J. BlahaTermedia Publishing Housearticleheart failurerisk assessmentcardiovascular diseaserisk predictionMedicineRENArchives of Medical Science, Vol 15, Iss 2, Pp 350-358 (2019)
institution DOAJ
collection DOAJ
language EN
topic heart failure
risk assessment
cardiovascular disease
risk prediction
Medicine
R
spellingShingle heart failure
risk assessment
cardiovascular disease
risk prediction
Medicine
R
Olusola A. Orimoloye
Swetha Kambhampati
Albert J. Hicks III
Mahmoud Al Rifai
Michael G. Silverman
Seamus Whelton
Waqas Qureshi
Jonathan K. Ehrman
Steven J. Keteyian
Clinton A. Brawner
Zeina Dardari
Mouaz H. Al-Mallah
Michael J. Blaha
Higher cardiorespiratory fitness predicts long-term survival in patients with heart failure and preserved ejection fraction: the Henry Ford Exercise Testing (FIT) Project
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 article
author Olusola A. Orimoloye
Swetha Kambhampati
Albert J. Hicks III
Mahmoud Al Rifai
Michael G. Silverman
Seamus Whelton
Waqas Qureshi
Jonathan K. Ehrman
Steven J. Keteyian
Clinton A. Brawner
Zeina Dardari
Mouaz H. Al-Mallah
Michael J. Blaha
author_facet Olusola A. Orimoloye
Swetha Kambhampati
Albert J. Hicks III
Mahmoud Al Rifai
Michael G. Silverman
Seamus Whelton
Waqas Qureshi
Jonathan K. Ehrman
Steven J. Keteyian
Clinton A. Brawner
Zeina Dardari
Mouaz H. Al-Mallah
Michael J. Blaha
author_sort Olusola A. Orimoloye
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_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_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_sort higher cardiorespiratory fitness predicts long-term survival in patients with heart failure and preserved ejection fraction: the henry ford exercise testing (fit) project
publisher Termedia Publishing House
publishDate 2019
url https://doaj.org/article/5c18893c77e04e52b674852786bb79ef
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