European journal of physical and rehabilitation medicine · 2026
Differential increase in peak oxygen uptake with cardiac rehabilitation among patients with stage B versus C heart failure.
СтатьяНаблюдательное исследованиеМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Yagi Eijiro, Matsumura Koichiro, Takabayashi Kensuke, Morimoto Junko, Ijichi Takeshi, Suzuki Daiki, Kurose Satoshi, Asada Shota, Hakozaki Shohei, Ueno Masafumi, Kimura Yutaka, Nakazawa Gaku
Аннотация
BACKGROUND: Although cardiac rehabilitation (CR) improves the exercise capacity of patients with cardiovascular disease, whether the magnitude of the benefit differs between patients with stage B versus C heart failure (HF) remains unclear.
AIM: To evaluate the impact of outpatient CR on the exercise capacity of patients with stage B versus C HF.
DESIGN: Multicenter retrospective observational study.
SETTING: Patients with stage B and stage C HF.
POPULATION: Outpatients underwent cardiac rehabilitation.
INTERVENTION: Not applicable.
METHODS: This multicenter retrospective study included 324 outpatients who underwent CR. Patients were classified by HF stage (B or C), and propensity score matching was performed. The primary endpoint was the change in peak oxygen uptake (peak VO<inf>2</inf>) from baseline to follow-up. Secondary outcomes were to identify factors associated with an increase in peak VO<inf>2</inf> in patients with stage B and C HF.
RESULTS: Of the 324 outpatients who underwent CR, patients were classified by HF stage (B or C), and propensity score matching was performed. Among the 254 matched patients, the peak VO<inf>2</inf> change was greater in those with stage B versus C HF (0.36 [0.00 to 0.89] vs. 0.22 [-0.12 to 0.22] mL/kg/min per month; P=0.04). Among patients with stage B HF, older age, higher Geriatric Nutritional Risk Index, lower skeletal muscle mass, and higher baseline peak VO<inf>2</inf> were associated with poor increase in peak VO<inf>2</inf>. Among patients with stage C HF, the presence of diabetes, lower handgrip strength, and higher Short Physical Performance Battery were associated with poor increases.
CONCLUSIONS: Peak VO<inf>2</inf> increased to a greater extent in patients with stage B versus C HF who underwent CR. Moreover, the clinical factors associated with exercise capacity gains differed by HF stage, underscoring the need to tailor CR strategies to each patient's disease stage and phenotype.
CLINICAL REHABILITATION IMPACT: The identification of stage-specific predictors of cardiac rehabilitation response underscores the importance of personalized rehabilitation strategies tailored to heart failure stage and patient phenotype, rather than relying on uniform protocols.
AIM: To evaluate the impact of outpatient CR on the exercise capacity of patients with stage B versus C HF.
DESIGN: Multicenter retrospective observational study.
SETTING: Patients with stage B and stage C HF.
POPULATION: Outpatients underwent cardiac rehabilitation.
INTERVENTION: Not applicable.
METHODS: This multicenter retrospective study included 324 outpatients who underwent CR. Patients were classified by HF stage (B or C), and propensity score matching was performed. The primary endpoint was the change in peak oxygen uptake (peak VO<inf>2</inf>) from baseline to follow-up. Secondary outcomes were to identify factors associated with an increase in peak VO<inf>2</inf> in patients with stage B and C HF.
RESULTS: Of the 324 outpatients who underwent CR, patients were classified by HF stage (B or C), and propensity score matching was performed. Among the 254 matched patients, the peak VO<inf>2</inf> change was greater in those with stage B versus C HF (0.36 [0.00 to 0.89] vs. 0.22 [-0.12 to 0.22] mL/kg/min per month; P=0.04). Among patients with stage B HF, older age, higher Geriatric Nutritional Risk Index, lower skeletal muscle mass, and higher baseline peak VO<inf>2</inf> were associated with poor increase in peak VO<inf>2</inf>. Among patients with stage C HF, the presence of diabetes, lower handgrip strength, and higher Short Physical Performance Battery were associated with poor increases.
CONCLUSIONS: Peak VO<inf>2</inf> increased to a greater extent in patients with stage B versus C HF who underwent CR. Moreover, the clinical factors associated with exercise capacity gains differed by HF stage, underscoring the need to tailor CR strategies to each patient's disease stage and phenotype.
CLINICAL REHABILITATION IMPACT: The identification of stage-specific predictors of cardiac rehabilitation response underscores the importance of personalized rehabilitation strategies tailored to heart failure stage and patient phenotype, rather than relying on uniform protocols.