Abstract 1554: Is Exercise Adherence Associated With Clinical Outcomes in Patients With Advanced Heart Failure?
BACKGROUND: Limited research exists to support the effect if exercise adherence in patients with heart failure (HF) on clinical outcomes. This secondary analysis was conducted on the intervention arm of an exercise training study in patients with HF to assess whether adherence and the “dose” of treatment exposure were associated with clinical outcomes, functional performance (peak VO2 anaerobic threshold and workload) and quality of life (QOL).
METHODS: Seventy-one patients (average age 54.0±12.5 years; predominantly male, 66%; Caucasian, 66%; married, 61%; New York Heart Association class II–III (97.2%); and average ejection fraction 26.4±6.5%) were included in the current study. Patients with an increase in the amount of exercise from baseline to 6 months of ≥18%, as measured by pedometers, were categorized as adherers (n=38); patients who had no change or an increase in the amount of exercise of ≤ 17% were categorized as non-adherers (n=33).
RESULTS: The two groups were significantly different in the composite endpoint of all cause hospitalization, ER admissions and death (Figure 1⇓). Adherers also had greater improvements in functional performance and QOL compared to non-adherers (p <.001); exercise dose was a significant independent predictor of change for these variables (p < .001).
CONCLUSION: These findings suggest that among patients with advanced HF adherence to exercise is associated with more favorable clinical outcomes. There is also a positive dose-response relationship between the amount of exercise performed and improvement in functional performance and QOL.
This research has received full or partial funding support from the American Heart Association, Western States Affiliate (California, Nevada & Utah).