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Quadriceps Strength and Mortality in Older Patients With Heart Failure
Takeshi Nakamura1, Kentaro Kamiya2, Nobuaki Hamazaki3
1Department of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan; Department of Rehabilitation, Juntendo University Hospital, Tokyo, Japan.
The Canadian Journal of Cardiology
|July 6, 2020
Summary
Low quadriceps isometric strength (QIS) in older heart failure (HF) patients is linked to a higher mortality risk. This strength measure adds significant prognostic value beyond existing HF severity and gait speed assessments.
Area of Science:
- Gerontology
- Cardiology
- Physical Therapy
Background:
- Older adults with heart failure (HF) face significant mortality risks.
- Assessing prognostic factors beyond traditional heart failure severity scores is crucial.
Purpose of the Study:
- To investigate the association between low quadriceps isometric strength (QIS) and mortality risk in older patients with HF.
- To determine if QIS provides additive prognostic value to existing heart failure risk scores and gait speed.
Main Methods:
- A retrospective cohort study included 1273 patients aged 60+ with HF.
- Quadriceps isometric strength (QIS) was measured as % of body mass, alongside gait speed.
- All-cause mortality was the primary endpoint over a median follow-up of 1.59 years.
Main Results:
- Low QIS (≤36.2% BM) was associated with a 1.55-fold increased hazard ratio for all-cause mortality after adjusting for HF risk score.
- Adding low QIS to HF risk score and gait speed significantly improved mortality prediction (NRI=0.239, IDI=0.004).
Conclusions:
- Low quadriceps isometric strength (QIS) is a significant independent predictor of mortality in older heart failure patients.
- QIS offers valuable complementary prognostic information, enhancing predictions made by HF risk scores and gait speed.
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