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Differential increase in peak oxygen uptake with cardiac rehabilitation among patients with stage B versus C heart
Eijiro Yagi1, Koichiro Matsumura2, Kensuke Takabayashi3
1Department of Cardiology, Kindai University Nara Hospital, Ikoma, Japan.
Insights
Cardiac rehabilitation (CR) significantly improves exercise capacity in heart failure (HF) patients. Stage B HF patients experienced greater peak oxygen uptake gains from CR compared to Stage C HF patients.
Area of Science:
- Cardiology
- Exercise Physiology
- Rehabilitation Medicine
Background:
- Cardiac rehabilitation (CR) is known to enhance exercise capacity in cardiovascular disease patients.
- However, the differential impact of CR on exercise capacity between stage B and stage C heart failure (HF) remains under investigation.
Purpose of the Study:
- To assess the effect of outpatient CR on exercise capacity in patients with stage B versus stage C HF.
- To identify factors influencing exercise capacity improvements in these patient groups.
Main Methods:
- A multicenter retrospective observational study was conducted.
- 324 outpatients undergoing CR were analyzed, classified by HF stage (B or C).
- Propensity score matching was used, with peak oxygen uptake (peak VO2) change as the primary endpoint.
Main Results:
- Among 254 matched patients, stage B HF patients showed a significantly greater increase in peak VO2 compared to stage C HF patients (0.36 vs. 0.22 mL/kg/min per month; P=0.04).
- For stage B HF, factors associated with poorer peak VO2 increase included older age, higher Geriatric Nutritional Risk Index, lower skeletal muscle mass, and higher baseline peak VO2.
- For stage C HF, diabetes, lower handgrip strength, and higher Short Physical Performance Battery scores were linked to poorer gains.
Conclusions:
- Patients with stage B HF demonstrate a more substantial improvement in peak oxygen uptake following CR than those with stage C HF.
- Clinical factors predicting CR response vary by HF stage, emphasizing the necessity for personalized CR strategies tailored to individual patient phenotypes and disease severity.
Background:
Although cardiac rehabilitation (CR) improves the exercise capacity of patients with cardiovascular disease, whether the magnitude of the benefit differs between patients with stage B versus C heart failure (HF) remains unclear.
Aim:
To evaluate the impact of outpatient CR on the exercise capacity of patients with stage B versus C HF.
Design:
Multicenter retrospective observational study.
Setting:
Patients with stage B and stage C HF.
Population:
Outpatients underwent cardiac rehabilitation.
Intervention:
Not applicable.
Methods:
This multicenter retrospective study included 324 outpatients who underwent CR. Patients were classified by HF stage (B or C), and propensity score matching was performed. The primary endpoint was the change in peak oxygen uptake (peak VO
Results:
Of the 324 outpatients who underwent CR, patients were classified by HF stage (B or C), and propensity score matching was performed. Among the 254 matched patients, the peak VO
Conclusions:
Peak VO
Clinical Rehabilitation Impact:
The identification of stage-specific predictors of cardiac rehabilitation response underscores the importance of personalized rehabilitation strategies tailored to heart failure stage and patient phenotype, rather than relying on uniform protocols.
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