Polish archives of internal medicine · 2026
Endurance capacity and muscle strength as a composite indicator of physical reserve in men with systolic heart failure.
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Żołyński Mikołaj S, Barecka Katarzyna, Krauze Tomasz, Piskorski Jarosław, Wykrętowicz Andrzej, O'Driscoll Jamie, Guzik Przemysław
Аннотация
INTRODUCTION: Reduced composite physical reserve (CPR) may coexist with systolic heart failure (HF).
OBJECTIVES: We aimed to evaluate clinical differences among patients stratified by CPR in the 6‑minute walk test (6MWT) and maximal handgrip (MHG) strength, and to identify clinical correlates of reduced physical function.
PATIENTS AND METHODS: This post hoc analysis included 332 men from a prospective cohort of outpatients with stable HF (left ventricular ejection fraction <50%) who completed both tests. The patients were stratified into 3 categories based on median splits of 6MWT (480 m) and MHG (40 kg) to define CPR: 1) both 6MWT and MHG values above the group medians; 2) either 6MWT or MHG at or below the median; or 3) both parameters at or below the median. Patient clinical characteristics were compared using analysis of covariance (estimated marginal means and SE) and logistic regression (odds ratios [ORs]), adjusted for age, diabetes, and smoking.
RESULTS: The category 3 patients had higher mean (SD) resting heart rate (72.2 [0.96] vs 64.4 [1.1] bpm; P <0.001), serum creatinine level (1.27 [0.03] vs 1.16 [0.04] mg/dl; P <0.001), and N-terminal pro-B-type natriuretic peptide level (log10 3.09 [0.05] vs 2.76 [0.05] pg/ml; P <0.001) than the category 1 patients. Each 1‑category increase was associated with greater odds of New York Heart Association class III-IV (OR, 2.6; 95% CI, 1.78-3.8), resting heart rate above 75 bpm (OR, 2.44; 95% CI, 1.64-3.64), chronic atrial fibrillation (OR, 1.53; 95% CI, 1.06-2.2), and increased use of diuretics (OR, 1.53; 95% CI, 1.02-2.29) and digoxin (OR, 1.99; 95% CI, 1.17-3.39).
CONCLUSIONS: Lower combined endurance and strength identify HF patients with a more severe clinical phenotype and greater treatment intensity. This functional performance-based categorization may offer a simple, promising tool for clinical phenotype stratification in systolic HF.
OBJECTIVES: We aimed to evaluate clinical differences among patients stratified by CPR in the 6‑minute walk test (6MWT) and maximal handgrip (MHG) strength, and to identify clinical correlates of reduced physical function.
PATIENTS AND METHODS: This post hoc analysis included 332 men from a prospective cohort of outpatients with stable HF (left ventricular ejection fraction <50%) who completed both tests. The patients were stratified into 3 categories based on median splits of 6MWT (480 m) and MHG (40 kg) to define CPR: 1) both 6MWT and MHG values above the group medians; 2) either 6MWT or MHG at or below the median; or 3) both parameters at or below the median. Patient clinical characteristics were compared using analysis of covariance (estimated marginal means and SE) and logistic regression (odds ratios [ORs]), adjusted for age, diabetes, and smoking.
RESULTS: The category 3 patients had higher mean (SD) resting heart rate (72.2 [0.96] vs 64.4 [1.1] bpm; P <0.001), serum creatinine level (1.27 [0.03] vs 1.16 [0.04] mg/dl; P <0.001), and N-terminal pro-B-type natriuretic peptide level (log10 3.09 [0.05] vs 2.76 [0.05] pg/ml; P <0.001) than the category 1 patients. Each 1‑category increase was associated with greater odds of New York Heart Association class III-IV (OR, 2.6; 95% CI, 1.78-3.8), resting heart rate above 75 bpm (OR, 2.44; 95% CI, 1.64-3.64), chronic atrial fibrillation (OR, 1.53; 95% CI, 1.06-2.2), and increased use of diuretics (OR, 1.53; 95% CI, 1.02-2.29) and digoxin (OR, 1.99; 95% CI, 1.17-3.39).
CONCLUSIONS: Lower combined endurance and strength identify HF patients with a more severe clinical phenotype and greater treatment intensity. This functional performance-based categorization may offer a simple, promising tool for clinical phenotype stratification in systolic HF.