Exploring factors related to good exercise capacity in patients undergoing ERIC-HF program

• Autor(a) principal: Delgado, Bruno
• Data de Publicação: 2022
• Outros Autores: Klompstra, Leonie, Lopes, Ivo, Novo, André
• Idioma: eng
• Título da fonte: Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
• Texto Completo: http://hdl.handle.net/10198/26753
• topic: Heart failure

Decompensated Heart Failure (HF) patients are characterized by functional dependence and low exercise capacity. The factors associated to a good response to exercise are still unexplored. The ERIC-HF program is an aerobic exercise training program developed for HF inpatients and includes cycloergometer training, walking and climbing stairs in order to promote patient’s functional capacity during the in-hospital stay period. Purpose: to identify the factors related to good response to an aerobic exercise training program for decompensated heart failure (HF) patients. Methods: Cross-sectional study with 143 inpatients who performed the ERIC-HF program. Functional capacity was evaluated using three different tools: the London Chest of Activity of Daily Living (LCADL) scale, the Barthel Index (BI) and the 6-minute walking test (6MWT). A good response to the program was defined as a ≥ 300 meters distance at the 6MWT at discharge. Univariate analysis was performed between patients who walked 300 meters or more at the 6MWT and patients who walked less than 300meters, using Chi-square tests and Student’s T-test. Logistic regression analysis was performed to describe factors that were independently related to better functional capacity at discharge. Variables with a p-value smaller than 0.15 in the univariate analyses were entered into the logistic regression. A significance level at p <0.05 was assumed. The dependent variables were: 1) distance walked at the 6MWT, 2) the change between admission-to-discharge scores of BI and 3) LCADL. Independent variables were: 1) gender, 2) age, 3) number of exercise sessions, 4) number of days of in-hospital stay, 5) BIad, 6) LCADLad, 7) NYHA functional class, 8) left ventricular ejection fraction (LVEF) and 9) etiology. Results: The mean age of the patients was 67 (±10) years, 15.4% were NYHA class IV and 80% had reduced ejection fraction. The aetiology of HF was similar between ischaemic disease (32.9%) and valvular (33.6%). Patients presented a high level of impairment on FC. The majority were male (97; 67.8%), with an average of three CVRF and mostly sedentary, with only 17% performing regular physical activity. There was no significant difference between etiologies of HF. Comparison between the group of patients who walked 300meters or more, at the 6MWT, and patients who walked less than 300metrs, showed statistically significant differences in terms of gender, age, BI, LCADL, etiology of HF and LVEF. After logistic regression, age (p = 0.002), gender (p = 0.001) and BI (p<0.000) at admission showed to be statistically significant factors that affect the distance walked. Conclusions: The ERIC-EF programe appears to be more effective in male, younger patients and with low FC at admission. Apparently, reduced ejection fraction does not interfere with progression during the programe. Gender influences the performance of patients, since men presented with higher FC at discharge.