Effect of change in hepato-renal function and cardiac rehabilitation on mortality in patients with heart failure.

Noda, Takumi; Kamiya, Kentaro; Hamazaki, Nobuaki; Nozaki, Kohei; Uchida, Shota; Ueno, Kensuke; Miki, Takashi; Hotta, Kazuki; Maekawa, Emi; Terada, Tasuku; Reed, Jennifer L; Yamaoka-Tojo, Minako; Matsunaga, Atsuhiko; Ako, Junya

Abstract

Patients with heart failure (HF) often suffer from hepato-renal dysfunction. The associations between hepato-renal function changes and mortality remain unclear. Further, the effect of cardiac rehabilitation (CR) on mortality and motor functions in patients with HF and hepato-renal dysfunction requires investigation. We reviewed 2522 patients with HF (63.2 % male; median age: 74 years). The association between changes in hepato-renal function assessed by the Model for End-stage Liver Disease eXcluding INR (MELD-XI) score and mortality was examined. The association of CR participation with mortality and physical functions was investigated in patients with HF with decreased, unchanged, and increased MELD-XI scores. During the follow-up period, 519 (20.6 %) patients died. Worsened MELD-XI score was independently associated with all-cause death [adjusted hazard ratio (aHR): 1.099; 95 % confidence interval (CI): 1.061-1.138; p < 0.001]. CR participation was associated with low mortality, even in the increased MELD-XI score group (aHR: 0.498; 95 % CI: 0.333-0.745; p < 0.001). Trajectory of the MELD-XI score was not associated with physical function changes. There were no time by MELD-XI score interaction effects on handgrip strength (p = 0.084), leg strength (p = 0.082), walking speed (p = 0.583), and 6-min walking distance (p = 0.833) in patients participating in outpatient CR. Hepato-renal dysfunction predicts high mortality. CR participation may be helpful for a better prognosis of patients with HF and hepato-renal dysfunction. [Abstract copyright: Copyright © 2024 Elsevier Ltd. All rights reserved.]

Citation

Noda, T., Kamiya, K., Hamazaki, N., Nozaki, K., Uchida, S., Ueno, K., Miki, T., Hotta, K., Maekawa, E., Terada, T., Reed, J. L., Yamaoka-Tojo, M., Matsunaga, A., & Ako, J. (2024). Effect of change in hepato-renal function and cardiac rehabilitation on mortality in patients with heart failure. Journal of Cardiology, 84(6), 355-361. https://doi.org/10.1016/j.jjcc.2024.06.006

• Journal Article Type: Article
• Acceptance Date: Jun 10, 2024
• Online Publication Date: Jul 2, 2024
• Publication Date: 2024-12
• Deposit Date: Oct 30, 2024
• Journal: Journal of cardiology
• Print ISSN: 0914-5087
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 84
• Issue: 6
• Pages: 355-361
• DOI: https://doi.org/10.1016/j.jjcc.2024.06.006
• Keywords: Sarcopenia, 6-minute walking test, Walking speed, Prognosis, Cardiac rehabilitation
• Public URL: https://nottingham-repository.worktribe.com/output/37300589
• Publisher URL: https://www.journal-of-cardiology.com/article/S0914-5087(24)00123-0/abstract