[Original Article]
Nakamura T, Kamiya K, Hamazaki N, Matsuzawa R, Nozaki K, Ichikawa T, Yamashita M, Maekawa E, Reed JL, Noda C, Meguro K,Yamaoka-Tojo M, Matsunaga A, Ako J. Can J Cardiol. 2020 Jul 2;S0828-282X(20)30582-1.
Background: This study was performed to test the hypothesis that low quadriceps isometric strength (QIS) were associated with greater risk of mortality and have the additive prognostic significance to heart failure (HF) severity and gait speed in older patients with heart failure.
Methods: A retrospective cohort study was performed in 1273 patients ≥60 years old with HF (mean age 75 ± 8 years, 59.1% men), in all of whom usual gait speed and maximal QIS had been evaluated during hospitalization. The QIS was expressed relative to body mass (% BM). The endpoint was all-cause mortality.
Results: Over a median follow-up period of 1.59 years (interquartile range, 0.58-3.42 years), 224 patients died. The cutoff value based on the Youden index for the QIS discriminating those at high risk of mortality was 36.2% BM for overall and we defined less than this cutoff point of QIS as low QIS. After adjustment for the HF risk score, the hazard ratio in low QIS was 1.55 for overall (95% confidence interval [CI]: 1.17-2.06). The addition of low QIS to the HF risk score and gait speed was associated with significant increases in both net reclassification improvement (NRI, 0.239 for overall; 95% CI: 0.096-0.381) and integrated discrimination improvement (IDI, 0.004 for overall; 95% CI: 0.001-0.009) for all-cause mortality.
Conclusions: Low QIS was strongly associated with poor prognosis and showed complementary prognostic predictive capability to the HF risk score and gait speed in older patients with HF.
PMID: 32622879