Rationale and study design of multicomponent exercise intervention for frail older patients with acutely decompensated heart failure: Pilot of the randomized controlled trial J REHAB-HF trial.

Background: In Japan, a growing number of older adults with heart failure (HF) are experiencing physical frailty. Healthcare providers recommend multicomponent exercise program for frail patients; however, their effectiveness in older Japanese adults with HF, who differ physiologically from their Western counterparts, remains unclear. In this study, we will compare the feasibility and efficacy of a multicomponent exercise program with those of conventional exercise therapy as pilot study of the randomized controlled trial, Japanese REHAB-HF (J REHAB-HF) trial.

Improved appendicular muscle strength predicts lower mortality in patients with heart failure.

Background: A decrease in general muscle strength is associated with a poor prognosis and lower physical function in patients with heart failure (HF). We examined whether improved appendicular muscle weakness (dynapenia) conditions would predict a better prognosis and improved physical functions in patients with HF.

Methods: Handgrip and leg strength were assessed before discharge (baseline) and after outpatient cardiac rehabilitation (CR) (follow-up), based on which patients were divided into four dynapenia conditions: non-dynapenia at baseline/follow-up, dynapenia at baseline/non-dynapenia at follow-up, non-dynapenia at baseline/dynapenia at follow-up, and dynapenia at baseline/follow-up.

Associations of Small-Airway Disease with Exercise Intolerance and Long-Term Outcomes in Patients with Heart Failure and Reduced or Preserved Ejection Fraction.

Introduction: Small airway is reportedly more susceptible than central airways in heart failure (HF), which may cause poor outcomes. We investigated clinical significance of small-airway disease (SAD) on exercise intolerance and clinical events in patients with HF and reduced or preserved left ventricular ejection fraction (LVEF).

Methods: We studied consecutive patients with HF admitted for medical treatment and measured maximum mid-expiratory flow (MMEF) on spirometry and 6-min walking distance (6MWD) at hospital discharge.

Effects of Acute Phase Intensive Exercise Training in Patients With Acute Decompensated Heart Failure.

Background: Acute decompensated heart failure (ADHF) leads to hospitalizations and functional decline in older adults. Although cardiac rehabilitation (CR) is effective for stable heart failure, its impact on ADHF patients, particularly those without frailty, is unclear.

Objectives: The goal of this study was to evaluate the efficacy and safety of early in-hospital CR for patients hospitalized with ADHF who are not frail.

Different effects of catheter ablation on exercise tolerance, leg strength, and quality of life in paroxysmal versus persistent atrial fibrillation.

Background: Catheter ablation (CA) can improve exercise tolerance and quality of life (QOL) in patients with atrial fibrillation (AF). However, its differential effects on muscle strength between paroxysmal AF (PAF) and nonparoxysmal AF (Non-PAF) remain unclear.

Methods: We evaluated 94 patients (67.

Associations of cognitive decline with outcomes of cardiovascular rehabilitation in patients with cardiovascular disease.

Background: Patients with cardiovascular disease (CVD) are often contending with various comorbidities including cognitive decline. Cognitive decline is a risk marker for adverse outcomes in these patients. On the other hand, cardiovascular rehabilitation (CVR) improves clinical outcomes.

Orthostatic Heart Rate Changes and Prognostic Outcomes in Patients With Heart Failure.

Background: Heart rate typically increases during postural changes from a supine to a standing position due to autonomic and hemodynamic factors. Changes in heart rate during orthostasis may reflect the extent of autonomic dysfunction in patients with heart failure (HF). Thus, orthostatic heart rate changes may be useful for evaluating autonomic function and may predict prognosis.

Association Between Amount of Physical Activity and Clinical Outcomes After Treatment for Cardiovascular Disease in Cancer Survivors.

Background: The present study aimed to investigate the association between physical activity before the incidence of cardiovascular disease (CVD) and clinical outcomes in cancer survivors.

Methods And Results: We analyzed 904 cancer survivors (median age [interquartile range] 75 [68-80] years; 297 [32.9%] patients were female) who required hospitalization for treatment of CVD.

Prognostic Value of Objective Social Isolation and Loneliness in Older Patients With Heart Failure: Subanalysis of FRAGILE-HF and Kitasato Cohort.

Background: Social factors encompass a broad spectrum of nonmedical factors, including objective (social isolation [SI]) and perceived (loneliness) conditions. Although social factors have attracted considerable research attention, information regarding their impact on patients with heart failure is scarce. We aimed to investigate the prognostic impact of objective SI and loneliness in older patients with heart failure.

Cancer history and physical function in patients with cardiovascular disease.

Both cancer and cardiovascular disease (CVD) cause skeletal muscle mass loss, thereby increasing the likelihood of a poor prognosis. We investigated the association between cancer history and physical function and their combined association with prognosis in patients with CVD. We retrospectively reviewed 3,796 patients with CVD (median age: 70 years; interquartile range [IQR]: 61-77 years) who had undergone physical function tests (gait speed and 6-minute walk distance [6MWD]) at discharge.

Screening for sarcopenia with SARC-F in older patients hospitalized with cardiovascular disease.

Aims: SARC-F ≥ 4 points are used for detecting sarcopenia; however, finding a lower SARC-F cut-off value may lead to early detection of sarcopenia. We investigated the SARC-F score with the highest sensitivity and specificity values to identify sarcopenia in older patients with cardiovascular disease (CVD). Motor performances were also examined for each SARC-F score.

Leg strength and incidence of heart failure in patients with acute coronary syndrome.

Aims: The risk of developing heart failure (HF) after acute coronary syndrome (ACS) remains high. It is unclear whether skeletal muscle strength, in addition to existing risk factors, is a predictor for developing HF after ACS. We aimed to clarify the relationship between quadriceps isometric strength (QIS), a skeletal muscle strength indicator, and the risk of developing HF in patients with ACS.

Association of sarcopenia defined by different skeletal muscle mass measurements with prognosis and quality of life in older patients with heart failure.

Background: Diagnosing sarcopenia in heart failure (HF) patients is important, but how to assess skeletal muscle mass in HF patients with fluid retention is controversial. We aimed to examine the association between sarcopenia, defined by different skeletal muscle mass measurements, and clinical outcomes in older HF patients.

Methods: We included 546 older HF patients (≥ 65 years) who were assessed for sarcopenia at discharge (median age 77 years, 309 males).

Effects of Acute Phase Intensive Physical Activity (ACTIVE-PA) Monitoring and Education for Cardiac Patients: Pilot Study of a Randomized Controlled Trial.

Background: Although physical activity (PA) decreases dramatically during hospitalization, an effective intervention method has not yet been established for this issue. We recently developed a multiperson PA monitoring system using information and communication technology (ICT) that can provide appropriate management and feedback about PA at the bedside or during rehabilitation. This ICT-based PA monitoring system can store accelerometer data on a tablet device within a few seconds and automatically display a graphical representation of activity trends during hospitalization.

The Association between the Level of Ankle-Brachial Index and the Risk of Poor Physical Function in Patients with Cardiovascular Disease.

Aims: The progression of atherosclerosis and decline in physical function are poor prognostic factors in patients with cardiovascular disease (CVD). The ankle-brachial index (ABI) is a widely used indicator of the degree of progression of atherosclerosis, which may be used to identify patients with CVD who are at risk of poor physical function. This study examined the association between ABI and poor physical function in patients with CVD.

Association between walking speed early after admission and all-cause death and/or re-admission in patients with acute decompensated heart failure.

Aims: Patients with heart failure (HF) frequently experience decreased physical function, including walking speed. Slower walking speed is associated with poorer prognosis. However, most of these reports focused on patients with stable HF, and the relationship between walking speed in acute phase and clinical outcomes is unclear.

Prognostic Utility of Skeletal Muscle Mass Metrics in Patients With Heart Failure.

Background: Sarcopenia is associated with risks of various adverse outcomes, and the assessment of skeletal muscle mass is necessary for its diagnosis. However, heart failure (HF) is a syndrome characterised by fluid retention, which affects muscle mass measurements. Different measurement methods have been reported to have different prognostic implications.

Trajectory of Abdominal Skeletal Muscle Changes During Cardiac Rehabilitation in Patients With Aortic Disease.

Objective: This study focused on routine computed tomography imaging for aortic disease management and evaluated the trajectory of skeletal muscle changes through inpatient and outpatient cardiac rehabilitation.

Design: Prospective observational study included patients who underwent abdominal computed tomography three times (baseline, postacute care, and follow-up). The area and density of the all-abdominal and erector spine muscles and intramuscular adipose tissue were measured.

Predictive value of cholinesterase in patients with heart failure: A new blood biochemical marker of undernutrition.

Background And Aims: This study was conducted to verify whether serum cholinesterase (ChE) is useful in predicting prognosis and discriminating undernutrition status compared to existing low-nutrition indices of blood chemical tests in patients with heart failure (HF).

Methods And Results: A total of 1617 patients (1204 older patients) with HF who evaluated ChE during hospitalization were recruited for this study. The primary outcome was all-cause death, and multivariate survival analysis was performed.

Prognostic impact of cachexia by multi-assessment in older adults with heart failure: FRAGILE-HF cohort study.

Background: Cachexia substantially impacts the prognosis of patients with heart failure (HF); however, there is no standard method for cachexia diagnosis. This study aimed to investigate the association of Evans's criteria, consisting of multiple assessments, with the prognosis of HF in older adults.

Methods: This study is a secondary analysis of the data from the FRAGILE-HF study, a prospective multicentre cohort study that enrolled consecutive hospitalized patients aged ≥65 years with HF.