A recent study has shown that walking speed can be a significant indicator of prognosis in patients with chronic heart failure. The research found that slower walking speeds were associated with an increased risk of cardiovascular death or worsening heart failure. However, grip strength and skeletal muscle mass index did not show the same correlation.
The study, conducted by a team of researchers led by Vladimir Ceyka of the Heart Failure Center at the University Hospital of Würzburg, Germany, was published in ESC Heart Failure on April 4th.
Heart failure is a condition in which the heart is unable to pump enough blood to meet the body's needs. It can be caused by a variety of factors, including coronary artery disease and weakened heart muscle. Patients with heart failure often experience a decline in muscle mass and strength, which can further exacerbate the condition.
The researchers noted that up to 20% of heart failure patients suffer from sarcopenia, a condition characterized by low muscle mass, strength, and physical performance. They sought to investigate the impact of walking speed, grip strength, and skeletal muscle mass index on cardiovascular outcomes in these patients.
The single-center prospective cohort study enrolled adults with stable chronic heart failure, including those previously diagnosed with a left ventricular ejection fraction (LVEF) of less than 40% and those with an LVEF of less than 50% at the time of enrollment.
Walking speed was measured using a 4-meter walk test, maximum grip strength was assessed using a hydraulic dynamometer, and skeletal muscle mass index was measured using dual-energy X-ray absorptiometry.
The primary outcome was defined as cardiovascular death or worsening heart failure. During a median follow-up period of 4.7 years, 52 of the 250 patients (78% male, average age 66, LVEF 37) experienced a primary event.
The analysis revealed that higher walking speeds were associated with a lower risk of cardiovascular death or worsening heart failure (hazard ratio (HR) = 0.81 per 0.1 m/s increase). In other words, for every 0.1 m/s increase in walking speed, the risk of cardiovascular death or worsening heart failure decreased by 19%.
In contrast, grip strength and skeletal muscle mass index did not show a significant association with the primary outcome.
"Higher walking speed was independently associated with a lower risk of cardiovascular death or worsening HF, whereas grip strength and ASMI were not," the researchers concluded. "This highlights the need to assess walking speed as a measure of physical performance with clear prognostic importance in HF patients."
This study underscores the importance of walking speed as a simple and effective tool for assessing prognosis in patients with chronic heart failure.
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