Abstract 11499: Asymptomatic Peripheral Arterial Disease is an Independent Limiting Factor for a Delay in Recovery From Reduced Exercise Capacity After Hospital Discharge in Patients With Chronic Heart Failure
Background:Reduced exercise capacity is well known to increase mortality in patients with chronic heart failure (CHF). Although a symptomatic peripheral arterial disease (PAD) decreases exercise capacity in CHF patients, the relation of an asymptomatic PAD to its reduction is still unknown. The purpose of this study was to investigate whether an asymptomatic PAD contributed to a delay in recovery from reduced exercise capacity after hospital discharge in CHF patients.
Methods: We studied 231 CHF patients (73 females) aged 65 ± 13 years who underwent a cardiac rehabilitation, after excluding patients with PAD of Fontaine stage 2 or more, patients on hemodialysis, or those who needed any assistance for walking. Patients were diagnosed to have an asymptomatic PAD of Fontaine stage 1, if their ankle-brachial index (ABI) measured at hospital discharge showed ≦0.90. They were divided into two groups based on 0.90 of ABI: PAD(+) and PAD(-) groups. We assessed patients’ characteristics including estimated glomerular filtration rate (eGFR) and number of supervised exercise training attended after hospital discharge. We also measured quadriceps isometric strength (QIS) as a parameter of muscle strength and six-minute walk distance (6MWD) as a parameter of exercise capacity at discharge and 5 months after the discharge. We examined the change in 6MWD between the two measurement points ([[Unable to Display Character: ⊿]]6MWD), while shorter [[Unable to Display Character: ⊿]]6MWD indicated more delayed in recovery from reduced exercise capacity. We compared all parameters between the two groups. Multiple regression analysis was used to detect limiting factors for [[Unable to Display Character: ⊿]]6MWD.
Results: Forty two patients (13 females) aged 68 ± 16 years were in the PAD(+) group. The QIS and 6MWD at discharge were significantly lower in the PAD(+) group than in the PAD(-) group (P<0.05 and P<0.01, respectively). Multiple regression analysis identified age (β=-0.336), sex (β=0.014), eGFR (β=0.202), number of supervised exercise training (β=0.179), 6MWD at discharge (β=-0.585), and ABI≦0.9 (β=-0.181) as significant independent limiting factors for [[Unable to Display Character: ⊿]]6MWD (P<0.05, respectively) (R2=0.29)
Conclusion: Asymptomatic PAD was an independent limiting factor for a delay in recovery from reduced exercise capacity after hospital discharge in patients with CHF.
Author Disclosures: S. Tanaka: None. T. Masuda: None. K. Kamiya: None. N. Hamazaki: None. R. Matsuzawa: None. K. Nozaki: None. R. Shimizu: None. Y. Kamada: None. A. Aoyama: None. C. Noda: None. E. Maekawa: None. M. Yamaoka-Tojo: None. J. Ako: None.
- © 2014 by American Heart Association, Inc.