Frequency of and Significance of Physical Frailty in Patients With Heart Failure

Abstract

Physical frailty is an important prognostic indicator in heart failure (HF); however, few studies have examined the relationship between physical frailty and invasive hemodynamics among adults with HF. The purpose of this study was to characterize physical frailty in HF in relation to invasive hemodynamics. We enrolled 49 patients with New York Heart Association (NYHA) Class II-IV HF when participants were scheduled for a right heart catheterization (RHC) procedure. Physical frailty was measured according to the Frailty Phenotype: shrinking, weakness, slowness, physical exhaustion, and low physical activity. Markers of invasive hemodynamics were derived from a formal review of RHC tracings, and projected survival was calculated using the Seattle HF Model (SHFM). The mean age of the sample (n = 49) was 57.4±9.7 years, 67% were male, 92% had NYHA Class III/IV HF, and 67% had non-ischemic HF. Physical frailty was identified in 24 participants (49%) and was associated with worse SHFM one-year projected survival (p = 0.007). After adjusting for projected survival, physically frail participants had lower cardiac index (by both thermodilution and the Fick equation) and higher heart rates compared with those not physically frail (all p < 0.05). In conclusion, physical frailty is highly prevalent in patients with HF and is associated with low-output HF.

Prognostic Importance of Hippocampal Atrophy in Patients With Chronic Heart Failure

“…Recently, research has focused on frailty, and reports have shown that frailty is associated with the prognosis of heart failure. 14 We intend to perform future studies to determine the relation between Table 1. * Per 1-SD increase.…”

Nutrition and mobility predict all-cause mortality in patients 12 months after transcatheter aortic valve implantation

“…Frailty is a geriatric syndrome, which is characterized by a vulnerable health status associated with declining function of multiple physiological systems and loss of physiological reserves with consecutive impairment of many domains (physical, social, nutritional, neuropsychological) [ 24 , 25 ]. The presence of frailty has been associated with poor medical outcomes in different cardiac patients such as patients with coronary artery disease [ 26 ] and chronic heart failure [ 27 ] as well as in patients undergoing cardiac surgery or TAVI. In 2012, Stortecky et al suggested a multidimensional geriatric assessment for TAVI candidates with a solid association with all-cause mortality and major cardiovascular events at 30 days and at 1-year follow-up [ 15 ].…”

Who needs a permanent pacemaker after transcatheter aortic valve implantation?

“…Frailty is a geriatric syndrome, which is characterized by a vulnerable health status associated with a declining function of multiple physiological systems and loss of physiological reserves with consecutive impairment of many domains (physical, social, nutritional, neuropsychological) (28). The presence of frailty has been associated with poor medical outcomes in different cardiac patients such as: patients with coronary artery disease (29) and chronic heart failure (30) as well as in patients undergoing TAVI. However, as this is multifactorial, frailty is diffi cult to capture, and it is timeconsuming to assess all components; it might be diffi cult to implement tests to determine this syndrome in clinical practice, such as at our institution.…”