Heart (British Cardiac Society) · 2025
Impact of cerebral oxygen saturation on mortality and rehospitalisation in patients with heart failure and the role of physical activity as a modifying factor: the HARVEST-Malmö Study.
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Zaghi Amir, Jujic Amra, Zilic Haris, Dieden Anna, Bachus Erasmus, Holm Hannes, Magnusson Martin
Аннотация
BACKGROUND: The cross-sectional association between cerebral tissue oxygen saturation (SctO2) and heart failure (HF) has been previously studied, but the prognostic significance of SctO2 in HF remains uncertain. This study aimed to assess the role of SctO2 as a risk factor for all-cause mortality and rehospitalisation, as well as to explore the cross-sectional association between physical activity and SctO2 in a Swedish HF cohort.
METHODS: In 102 patients with HF (mean age 70.2 years (±12.4); 21.6% women), near-infrared spectroscopy was used to assess SctO2. Adjusted Cox regression analyses were conducted to examine the associations between resting SctO2 levels and all-cause mortality and the initial occurrence of postdischarge rehospitalisations. The associations between self-reported physical inactivity and SctO2 were explored by using multivariable linear and logistic regression analyses.
RESULTS: The median follow-up time to death of any cause and first-of-any rehospitalisation was 830 (IQR: 519-1283) and 208 (72-584) days, respectively. During follow-up, 31 (30.4%) patients died and 63 (61.8%) were rehospitalised. Higher SctO2 was associated with lower risk of mortality (HR 0.86; 95% CI 0.77 to 0.95; p=0.002) but not with rehospitalisation risk (HR 0.96; 95% CI 0.90 to 1.02; p=0.162). Physical inactivity (≤1 hour per week of strenuous activity) was associated with lower SctO2 (β-1.56; 95% CI -3.07 to -0.05, p=0.043).
CONCLUSION: Higher SctO2 at rest is associated with lower risk of all-cause mortality but it was not possible to show significant association with first-of-any rehospitalisation risk in patients with HF. Physical inactivity is associated with lower cerebral oxygen saturation at rest. These findings could suggest SctO2 as a potential marker associated with long-term outcomes in HF, warranting larger confirmatory studies.
METHODS: In 102 patients with HF (mean age 70.2 years (±12.4); 21.6% women), near-infrared spectroscopy was used to assess SctO2. Adjusted Cox regression analyses were conducted to examine the associations between resting SctO2 levels and all-cause mortality and the initial occurrence of postdischarge rehospitalisations. The associations between self-reported physical inactivity and SctO2 were explored by using multivariable linear and logistic regression analyses.
RESULTS: The median follow-up time to death of any cause and first-of-any rehospitalisation was 830 (IQR: 519-1283) and 208 (72-584) days, respectively. During follow-up, 31 (30.4%) patients died and 63 (61.8%) were rehospitalised. Higher SctO2 was associated with lower risk of mortality (HR 0.86; 95% CI 0.77 to 0.95; p=0.002) but not with rehospitalisation risk (HR 0.96; 95% CI 0.90 to 1.02; p=0.162). Physical inactivity (≤1 hour per week of strenuous activity) was associated with lower SctO2 (β-1.56; 95% CI -3.07 to -0.05, p=0.043).
CONCLUSION: Higher SctO2 at rest is associated with lower risk of all-cause mortality but it was not possible to show significant association with first-of-any rehospitalisation risk in patients with HF. Physical inactivity is associated with lower cerebral oxygen saturation at rest. These findings could suggest SctO2 as a potential marker associated with long-term outcomes in HF, warranting larger confirmatory studies.