The Acute-Phase Ambulation Program Improves Clinical Outcome for Acute Heart Failure

Area of Science:

• Cardiology
• Internal Medicine
• Clinical Research

Background:

• Prognosis of acute heart failure (HF) patients remains a clinical challenge.
• The effectiveness of acute-phase ambulation programs (AAP) in improving HF patient outcomes is not well-established.

Purpose of the Study:

• To investigate the association between the initiation of an acute-phase ambulation program (AAP) and the prognosis of patients experiencing worsening heart failure (HF).

Main Methods:

• Retrospective analysis of 560 consecutive patients admitted for worsening HF from March 2019 to April 2021.
• Comparison of cardiac events within 180 days post-discharge between a conventional care group (pre-May 2020) and an AAP group (post-May 2020).
• Primary endpoints included all-cause mortality and HF readmission; multivariate analysis adjusted for clinical factors.

Main Results:

• Kaplan-Meier survival analysis revealed significantly lower HF readmission rates and primary endpoint events in the AAP group (p=0.020 and p=0.014, respectively).
• Multivariate analysis identified AAP participation as an independent factor associated with a reduced risk of the primary endpoint (HR 0.62; 95% CI 0.41-0.95; p=0.028), after adjusting for age, HF history, blood pressure, medications, hemoglobin, and NT-proBNP.
• Key factors associated with the primary endpoint included age, HF history, systolic blood pressure, renin-angiotensin system inhibitors/angiotensin receptor blockers, hemoglobin, and NT-proBNP levels.

Conclusions:

• Initiation of an acute-phase ambulation program (AAP) is associated with improved short-term prognosis in patients with acute heart failure.
• AAP participation independently reduces the risk of adverse cardiac events, including mortality and readmission, within 180 days post-discharge.
• Implementation of AAP for acute heart failure patients should be strongly considered to enhance clinical outcomes.