Inspiratory muscle strength and six-minute walking distance in heart failure : prognostic utility in a 10 years follow up cohort study
Gorde:
| Egile nagusia: | |
|---|---|
| Argitaratze data: | 2019 |
| Beste egile batzuk: | , , , , , |
| Formatua: | Article |
| Hizkuntza: | eng |
| Baliabidea: | Repositório Institucional da UnB |
| Download full: | http://repositorio.unb.br/handle/10482/51498 https://doi.org/10.1371/journal.pone.0220638 https://orcid.org/0000-0001-8444-2655 |
Gaia: | Background Maximal inspiratory pressure (PImax) and 6-minutes walk distance test (6MWD) may be more available and feasible alternatives for prognostic assessment than cardiopulmonary testing. We hypothesized that the PImax and 6MWD combination could improve their individual accuracy as risk predictors. We aimed to evaluate PImax ability as a mortality predictor in HF and whether the combination to 6MWD could improve risk stratification. Methods Prospective cohort from HF Clinics of three University Hospitals. PImax, 6MWD and pVO2 were obtained at baseline. The end point was all cause mortality. Results Consecutive 256 individuals (50% woman, 57.4±10.4years) with low ejection fraction (LVEF) (31.8±8.6%) were followed up to 10years. During a median follow-up of 34.7 (IQR 37) months, 110 participants died. Mean±SD values were: pVO2 14.9±5.1mL/kg/min, PImax 5.5±1.3kPa and 6MWD 372±118m. In multivariate Cox regression, pVO2, PImax, 6MWD and LVEF were independent mortality predictors. The pVO2 showed gold standard accuracy, followed by PImax (AUC = 0.84) and 6MWD (AUC = 0.74). Kaplan-Meier mean survival time (MST±SE) for lower (≤5.0kPa) and higher (>6.0kPa) PImax tertiles, were 37.9±2.8months and 105.0±5.2months respectively, and addition of 6MWD did not restratified risk. For intermediate PImax tertile, MST was 81.5±5.5months, but adding 6MWD, MST was lower (53.3±7.6months) if distance was ≤350m and higher (103.1±5.7months) for longer distances. Conclusion PImax is an independent mortality predictor in HF, more accurate than 6MWD and LVEF. Addition of 6MWD empowers risk stratification only for intermediate PImax tertile. Although less accurate than pVO2, this simpler approach could be a feasible alternative as a prognostic assessment. |
| _version_ | 1871442377653092352 |
|---|---|
| author | Ramalho, Sergio Henrique Rodolpho |
| author2 | Cipriano Júnior, Gérson Vieira, Paulo José Cardoso Nakano, Eduardo Yoshio Winkelmann, Eliane R. Callegaro, Carine C. Chiappa, Gaspar Rogério |
| author2_role | author author author author author author |
| author_browse | Callegaro, Carine C. Chiappa, Gaspar Rogério Cipriano Júnior, Gérson Nakano, Eduardo Yoshio Ramalho, Sergio Henrique Rodolpho Vieira, Paulo José Cardoso Winkelmann, Eliane R. |
| author_facet | Ramalho, Sergio Henrique Rodolpho Cipriano Júnior, Gérson Vieira, Paulo José Cardoso Nakano, Eduardo Yoshio Winkelmann, Eliane R. Callegaro, Carine C. Chiappa, Gaspar Rogério |
| author_role | author |
| bitstream.checksum.fl_str_mv | 9e3e76690cef0bb6474862557c63e6ad aed4704d04bb260d4decd80db311aaa5 |
| bitstream.checksumAlgorithm.fl_str_mv | MD5 MD5 |
| bitstream.url.fl_str_mv | http://repositorio.unb.br/bitstream/10482/51498/1/ARTIGO_InspiratoryMuscleStrength.pdf http://repositorio.unb.br/bitstream/10482/51498/2/license.txt |
| collection | Repositório Institucional da UnB |
| dc.contributor.affiliation.pt_BR.fl_str_mv | University of Brasília, Health Sciences and Technologies Program University of Brasília, Health Sciences and Technologies Program University of Brasília, Rehabilitation Sciences Program Intensive Care Unit of the Hospital Cristo Redentor, Porto Alegre, Brazil Department of Statistics, University of Brasilia Universidade Regional do Noroeste do Estado do Rio Grande do Sul Department of Physiotherapy, Federal University of Santa Maria University of Brasília, Health Sciences and Technologies Program Faculdades Integradas da União Educacional do Planalto Central |
| dc.contributor.author.fl_str_mv | Ramalho, Sergio Henrique Rodolpho Cipriano Júnior, Gérson Vieira, Paulo José Cardoso Nakano, Eduardo Yoshio Winkelmann, Eliane R. Callegaro, Carine C. Chiappa, Gaspar Rogério |
| dc.date.accessioned.fl_str_mv | 2025-02-07T12:30:32Z |
| dc.date.available.fl_str_mv | 2025-02-07T12:30:32Z |
| dc.date.issued.fl_str_mv | 2019-08-01 |
| dc.identifier.citation.fl_str_mv | RAMALHO, Sergio Henrique Rodolpho et al. Inspiratory muscle strength and six-minute walking distance in heart failure: prognostic utility in a 10 years follow up cohort study. Plos One, [S. l.], v. 14, n. 8, e0220638, 2019. DOI: https://doi.org/10.1371/journal.pone.0220638. Disponível em: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0220638. Acesso em: 07 fev. 2025. |
| dc.identifier.doi.pt_BR.fl_str_mv | https://doi.org/10.1371/journal.pone.0220638 |
| dc.identifier.orcid.pt_BR.fl_str_mv | https://orcid.org/0000-0001-8444-2655 |
| dc.identifier.uri.fl_str_mv | http://repositorio.unb.br/handle/10482/51498 |
| dc.language.iso.fl_str_mv | eng |
| dc.publisher.none.fl_str_mv | Plos One |
| dc.rights.driver.fl_str_mv | info:eu-repo/semantics/openAccess |
| dc.source.none.fl_str_mv | reponame:Repositório Institucional da UnB instname:Universidade de Brasília (UnB) instacron:UNB |
| dc.subject.keyword.pt_BR.fl_str_mv | Insuficiência cardíaca Músculos respiratórios Teste de exercício cardiopulmonar |
| dc.title.pt_BR.fl_str_mv | Inspiratory muscle strength and six-minute walking distance in heart failure : prognostic utility in a 10 years follow up cohort study |
| dc.type.driver.fl_str_mv | info:eu-repo/semantics/article |
| dc.type.status.fl_str_mv | info:eu-repo/semantics/publishedVersion |
| description | Background Maximal inspiratory pressure (PImax) and 6-minutes walk distance test (6MWD) may be more available and feasible alternatives for prognostic assessment than cardiopulmonary testing. We hypothesized that the PImax and 6MWD combination could improve their individual accuracy as risk predictors. We aimed to evaluate PImax ability as a mortality predictor in HF and whether the combination to 6MWD could improve risk stratification. Methods Prospective cohort from HF Clinics of three University Hospitals. PImax, 6MWD and pVO2 were obtained at baseline. The end point was all cause mortality. Results Consecutive 256 individuals (50% woman, 57.4±10.4years) with low ejection fraction (LVEF) (31.8±8.6%) were followed up to 10years. During a median follow-up of 34.7 (IQR 37) months, 110 participants died. Mean±SD values were: pVO2 14.9±5.1mL/kg/min, PImax 5.5±1.3kPa and 6MWD 372±118m. In multivariate Cox regression, pVO2, PImax, 6MWD and LVEF were independent mortality predictors. The pVO2 showed gold standard accuracy, followed by PImax (AUC = 0.84) and 6MWD (AUC = 0.74). Kaplan-Meier mean survival time (MST±SE) for lower (≤5.0kPa) and higher (>6.0kPa) PImax tertiles, were 37.9±2.8months and 105.0±5.2months respectively, and addition of 6MWD did not restratified risk. For intermediate PImax tertile, MST was 81.5±5.5months, but adding 6MWD, MST was lower (53.3±7.6months) if distance was ≤350m and higher (103.1±5.7months) for longer distances. Conclusion PImax is an independent mortality predictor in HF, more accurate than 6MWD and LVEF. Addition of 6MWD empowers risk stratification only for intermediate PImax tertile. Although less accurate than pVO2, this simpler approach could be a feasible alternative as a prognostic assessment. |
| eu_rights_str_mv | openAccess |
| format | article |
| id | UNB_7dc7b15a98eaead6a45fe929ea8eb036 |
| identifier_str_mv | RAMALHO, Sergio Henrique Rodolpho et al. Inspiratory muscle strength and six-minute walking distance in heart failure: prognostic utility in a 10 years follow up cohort study. Plos One, [S. l.], v. 14, n. 8, e0220638, 2019. DOI: https://doi.org/10.1371/journal.pone.0220638. Disponível em: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0220638. Acesso em: 07 fev. 2025. |
| instacron_str | UNB |
| institution | UNB |
| instname_str | Universidade de Brasília (UnB) |
| language | eng |
| network_acronym_str | UNB |
| network_name_str | Repositório Institucional da UnB |
| oai_identifier_str | oai:repositorio.unb.br:10482/51498 |
| publishDate | 2019 |
| publishDateSort | 2019 |
| publisher.none.fl_str_mv | Plos One |
| reponame_str | Repositório Institucional da UnB |
| repository.mail.fl_str_mv | repositorio@unb.br |
| repository.name.fl_str_mv | Repositório Institucional da UnB - Universidade de Brasília (UnB) |
| repository_id_str | |
| spelling | Ramalho, Sergio Henrique RodolphoCipriano Júnior, GérsonVieira, Paulo José CardosoNakano, Eduardo YoshioWinkelmann, Eliane R.Callegaro, Carine C.Chiappa, Gaspar RogérioUniversity of Brasília, Health Sciences and Technologies ProgramUniversity of Brasília, Health Sciences and Technologies ProgramUniversity of Brasília, Rehabilitation Sciences ProgramIntensive Care Unit of the Hospital Cristo Redentor, Porto Alegre, BrazilDepartment of Statistics, University of BrasiliaUniversidade Regional do Noroeste do Estado do Rio Grande do SulDepartment of Physiotherapy, Federal University of Santa MariaUniversity of Brasília, Health Sciences and Technologies ProgramFaculdades Integradas da União Educacional do Planalto Central2025-02-07T12:30:32Z2025-02-07T12:30:32Z2019-08-01RAMALHO, Sergio Henrique Rodolpho et al. Inspiratory muscle strength and six-minute walking distance in heart failure: prognostic utility in a 10 years follow up cohort study. Plos One, [S. l.], v. 14, n. 8, e0220638, 2019. DOI: https://doi.org/10.1371/journal.pone.0220638. Disponível em: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0220638. Acesso em: 07 fev. 2025.http://repositorio.unb.br/handle/10482/51498https://doi.org/10.1371/journal.pone.0220638https://orcid.org/0000-0001-8444-2655engPlos OneThis is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.info:eu-repo/semantics/openAccessInspiratory muscle strength and six-minute walking distance in heart failure : prognostic utility in a 10 years follow up cohort studyinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleInsuficiência cardíacaMúsculos respiratóriosTeste de exercício cardiopulmonarBackground Maximal inspiratory pressure (PImax) and 6-minutes walk distance test (6MWD) may be more available and feasible alternatives for prognostic assessment than cardiopulmonary testing. We hypothesized that the PImax and 6MWD combination could improve their individual accuracy as risk predictors. We aimed to evaluate PImax ability as a mortality predictor in HF and whether the combination to 6MWD could improve risk stratification. Methods Prospective cohort from HF Clinics of three University Hospitals. PImax, 6MWD and pVO2 were obtained at baseline. The end point was all cause mortality. Results Consecutive 256 individuals (50% woman, 57.4±10.4years) with low ejection fraction (LVEF) (31.8±8.6%) were followed up to 10years. During a median follow-up of 34.7 (IQR 37) months, 110 participants died. Mean±SD values were: pVO2 14.9±5.1mL/kg/min, PImax 5.5±1.3kPa and 6MWD 372±118m. In multivariate Cox regression, pVO2, PImax, 6MWD and LVEF were independent mortality predictors. The pVO2 showed gold standard accuracy, followed by PImax (AUC = 0.84) and 6MWD (AUC = 0.74). Kaplan-Meier mean survival time (MST±SE) for lower (≤5.0kPa) and higher (>6.0kPa) PImax tertiles, were 37.9±2.8months and 105.0±5.2months respectively, and addition of 6MWD did not restratified risk. For intermediate PImax tertile, MST was 81.5±5.5months, but adding 6MWD, MST was lower (53.3±7.6months) if distance was ≤350m and higher (103.1±5.7months) for longer distances. Conclusion PImax is an independent mortality predictor in HF, more accurate than 6MWD and LVEF. Addition of 6MWD empowers risk stratification only for intermediate PImax tertile. Although less accurate than pVO2, this simpler approach could be a feasible alternative as a prognostic assessment.Faculdade de Ciências e Tecnologias em Saúde (FCTS) – Campus UnB CeilândiaPrograma de Pós-Graduação em Ciências e Tecnologias em SaúdePrograma de Pós-Graduação em Ciências da Reabilitaçãoreponame:Repositório Institucional da UnBinstname:Universidade de Brasília (UnB)instacron:UNBORIGINALARTIGO_InspiratoryMuscleStrength.pdfARTIGO_InspiratoryMuscleStrength.pdfapplication/pdf833470http://repositorio.unb.br/bitstream/10482/51498/1/ARTIGO_InspiratoryMuscleStrength.pdf9e3e76690cef0bb6474862557c63e6adMD51open accessLICENSElicense.txtlicense.txttext/plain102http://repositorio.unb.br/bitstream/10482/51498/2/license.txtaed4704d04bb260d4decd80db311aaa5MD52open access10482/514982025-02-07 09:30:33.762open accessoai:repositorio.unb.br:10482/51498U3VibWlzc8OjbyBlZmV0aXZhZGEgZGUgYWNvcmRvIGNvbSBsaWNlbsOnYSBjb25jZWRpZGEgcGVsbyBhdXRvciBlL291IGRldGVudG9yIGRvcyBkaXJlaXRvcyBhdXRvcmFpcy4KRepositório InstitucionalPUBhttps://repositorio.unb.br/oai/requestrepositorio@unb.bropendoar:2025-02-07T12:30:33Repositório Institucional da UnB - Universidade de Brasília (UnB) |
| spellingShingle | Inspiratory muscle strength and six-minute walking distance in heart failure : prognostic utility in a 10 years follow up cohort study Ramalho, Sergio Henrique Rodolpho Insuficiência cardíaca Músculos respiratórios Teste de exercício cardiopulmonar |
| status_str | publishedVersion |
| title | Inspiratory muscle strength and six-minute walking distance in heart failure : prognostic utility in a 10 years follow up cohort study |
| title_full | Inspiratory muscle strength and six-minute walking distance in heart failure : prognostic utility in a 10 years follow up cohort study |
| title_fullStr | Inspiratory muscle strength and six-minute walking distance in heart failure : prognostic utility in a 10 years follow up cohort study |
| title_full_unstemmed | Inspiratory muscle strength and six-minute walking distance in heart failure : prognostic utility in a 10 years follow up cohort study |
| title_short | Inspiratory muscle strength and six-minute walking distance in heart failure : prognostic utility in a 10 years follow up cohort study |
| title_sort | Inspiratory muscle strength and six-minute walking distance in heart failure : prognostic utility in a 10 years follow up cohort study |
| topic | Insuficiência cardíaca Músculos respiratórios Teste de exercício cardiopulmonar |
| url | http://repositorio.unb.br/handle/10482/51498 https://doi.org/10.1371/journal.pone.0220638 https://orcid.org/0000-0001-8444-2655 |