Prognostic Value of Leg Muscle Strength in Acute Heart Failure Syndrome

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Introduction Leg muscle strength (LMS) may be useful as a frailty index in patients with heart failure. However, LMS, until recently, has been indirectly estimated, and its prognostic value in acute heart failure syndrome (AHFS) is unclear. Therefore, we evaluated the prognostic value of direct LMS assessment and its relationship with proinflammatory mediators in patients with AHFS. Methods We directly measured LMS at predischarge using a dynamometer in 110 prospectively and consecutively enrolled patients with AHFS (75 male; 60 +/- 14 yr; mean ejection fraction, 29.9% +/- 14.6%). The primary end point was cardiovascular (CV) events, defined as CV mortality, cardiac transplantation, or rehospitalization due to heart failure aggravation. Patients were divided into impaired and preserved LMS groups according to Contal and O'Quigley's method. Results CV events occurred in 28 patients (25.5%) (including 5 CV deaths and 6 cardiac transplantations) during follow-up (median, 246 d; range = 11-888 d). Impaired LMS was associated with significantly higher levels of serum monokine induced by gamma interferon and poor clinical outcomes (P < 0.001). Multivariable Cox proportional hazard analysis (controlling for age, sex, body mass index, heart failure type, hemoglobin level, N-terminal pro-b-type natriuretic peptide level, and beta-blocker use) revealed LMS as an independent predictor of CV events (P = 0.017). Conclusion Impaired LMS, which might be used as a marker of frailty, is associated with increased levels of a proinflammatory chemokine and independently predicts clinical outcomes in patients with AHFS. The direct measurement of LMS is simple and feasible and might have important implications for the risk stratification of patients with AHFS.
Publisher
LIPPINCOTT WILLIAMS &amp; WILKINS
Issue Date
2021-01
Language
English
Article Type
Article
Citation

MEDICINE AND SCIENCE IN SPORTS AND EXERCISE, v.53, no.1, pp.19 - 25

ISSN
0195-9131
DOI
10.1249/MSS.0000000000002432
URI
http://hdl.handle.net/10203/280010
Appears in Collection
MSE-Journal Papers(저널논문)
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