Abstract
BackgroundSeveral studies have examined the role of physical activity as a predictor of heart failure (HF) mortality and morbidity. Here, we aimed to evaluate the role of self-reported physical activity as an independent risk factor of post-discharge mortality and re-hospitalization in patients hospitalized for HF, as well as study the association between physical activity and 92 plasma proteins associated with cardiovascular disease (CVD).MethodsFour-hundred-and-thirty-four patients hospitalized for HF (mean age 75 years; 32% women) were screened for physical activity derived from questionnaires in the Swedish national public health survey. The median follow-up time to death and re-hospitalization was 835 (interquartile range, 390–1,432) and 157 (43–583) days, respectively. Associations between baseline reported physical activity, mortality and re-hospitalization risk were analyzed using multivariable Cox regression analysis. Plasma samples from 295 study participants were analyzed with a proximity extension assay consisting of 92 proteins. Associations between proteins and physical activity were explored using a false discovery rate of <5%, and significant associations were taken forward to multivariate analyses.ResultsIn the multivariate Cox regression model, physical inactivity, defined as physical activity time <1 h throughout the week was associated with increased risk of all-cause mortality (HR 1.71; CI95% 1.26–2.31; p = 5.9 × 10−4) as well as all-cause re-hospitalization (HR 1.27; CI95% 1.01–1.60; p = 0.038). Further, physical inactivity was associated with elevated plasma levels of Metalloproteinase inhibitor 4, Soluble interleukin 1 receptor-like 1, Elafin and Transferrin receptor protein 1, which are implicated in myocardial fibrosis, migration and apoptosis.ConclusionsSelf-reported low weekly physical activity is associated with increased risk of mortality and re-hospitalization in patients hospitalized for HF independent of traditional risk factors. Furthermore, physical inactivity was associated with elevated levels of 4 proteins linked to cardiovascular disease.
Highlights
Heart failure (HF) is globally gaining in prevalence with an increasing burden on societies both in terms of quality of life and healthcare expenditures [1]
The data on the survival benefit of exercise-based cardiac rehabilitation appears to be most significant in patients who are in a vulnerable phase of HF, e.g., patients discharged after an episode of decompensated HF
We showed that physical inactivity or the absence of regular weekly physical activity of medium intensity (≥1 h/week over the past 12 months prior to hospitalization for heart failure) is associated with increased risk for mortality and re-hospitalization, independent of traditional risk factors
Summary
Heart failure (HF) is globally gaining in prevalence with an increasing burden on societies both in terms of quality of life and healthcare expenditures [1]. While studies on the benefits of exercise-based cardiac rehabilitation in patients with chronic HF [ HF with reduced ejection fraction (HFrEF)] have shown only modest benefit on mortality and hospitalization at a population level [6], reduction in these endpoints appeared to be significant in the elderly and ischemic patients [7]. A notable prospective observational study examining the predictive role of physical activity on mortality in patients with severe. Several studies have examined the role of physical activity as a predictor of heart failure (HF) mortality and morbidity. We aimed to evaluate the role of self-reported physical activity as an independent risk factor of post-discharge mortality and re-hospitalization in patients hospitalized for HF, as well as study the association between physical activity and 92 plasma proteins associated with cardiovascular disease (CVD)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
