Abstract
Introduction: Leg muscle strength (LMS) could be an index of frailty in patients with heart failure. However, its prognostic value in patients with acute decompensated heart failure (ADHF) is not well investigated. Hypothesis: We hypothesized that impaired LMS was independently associated with poor clinical outcome in patients with ADHF. Methods: We measured LMS in 110 prospectively and consecutively enrolled ADHF patients (75 male, mean age 60 ± 14 years, mean ejection fraction 29.9 ± 14.6%) at predischarge period. Primary endpoint was cardiovascular (CV) events defined as CV mortality, cardiac transplantation or rehospitalization due to HF aggravation. Results: The CV events occurred in 28 (25.5%) patients (5 cardiovascular deaths and 6 cardiac transplantations) during follow up period (median 246 days, 11-888 days). When the patients with ADHF were divided by LMS according to Contal and O’Quigley's method, impaired LMS was shown to be associated with poor clinical outcome (P<0.001). Multivariate Cox regression analysis revealed that LMS was found to be an independent predictor of CV events (P=0.017) when controlled for age, gender, BMI, types of heart failure, hemoglobin, NT-proBNP and beta-blocker use. Conclusions: LMS independently predicts clinical outcome in patients with ADHF and might be used as a surrogate marker of frailty. Further studies are needed to evaluate the prognostic role of leg muscle strengthening exercise in these patients.
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