Incremental Value of Gait Speed in Predicting Prognosis of Older Adults With Heart Failure : Insights From the IMAGE-HF Study
Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved..
OBJECTIVES: The aim of this study was to assess the relationship between gait speed and the risk for death and/or hospital admission in older patients with heart failure (HF).
BACKGROUND: Gait speed is a reliable single marker of frailty in older people and can predict falls, disability, hospital admissions, and mortality.
METHODS: In total, 331 community-living patients ≥70 years of age (mean age 78 ± 6 years, 43% women, mean ejection fraction 35 ± 11%, mean New York Heart Association functional class 2.7 ± 0.6) in stable condition and receiving optimized therapy for chronic HF were prospectively enrolled and followed for 1 year. Gait speed was measured at the usual pace over 4 m, and cutoffs were defined by tertiles: ≤0.65, 0.66 to 0.99, and ≥1.0 m/s.
RESULTS: There was a significant association between gait speed tertiles and 1-year mortality: 38.3%, 21.9%, and 9.1% (p < 0.001), respectively. On multivariate analysis, gait speed was associated with a lower risk for all-cause death (hazard ratio: 0.62; 95% confidence interval: 0.43 to 0.88) independently of age, ejection fraction <20%, systolic blood pressure, anemia, and absence of beta-blocker therapy. Gait speed was also associated with a lower risk for hospitalization for HF and all-cause hospitalization. When gait speed was added to the multiparametric Cardiac and Comorbid Conditions Heart Failure risk score, it improved the accuracy of risk stratification for all-cause death (net reclassification improvement 0.49; 95% confidence interval: 0.26 to 0.73, p < 0.001) and HF admissions (net reclassification improvement 0.37; 95% confidence interval: 0.15 to 0.58; p < 0.001).
CONCLUSIONS: Gait speed is independently associated with death, hospitalization for HF, and all-cause hospitalization and improves risk stratification in older patients with HF evaluated using the Cardiac and Comorbid Conditions Heart Failure score. Assessment of frailty using gait speed is simple and should be part of the clinical evaluation process.
| Errataetall: |
CommentIn: JACC Heart Fail. 2016 Apr;4(4):299-300. - PMID 27033017 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2016 |
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| Erschienen: |
2016 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:4 |
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| Enthalten in: |
JACC. Heart failure - 4(2016), 4 vom: 01. Apr., Seite 289-98 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Pulignano, Giovanni [VerfasserIn] |
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| Links: |
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| Themen: |
Elderly |
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| Anmerkungen: |
Date Completed 10.01.2017 Date Revised 08.04.2022 published: Print-Electronic CommentIn: JACC Heart Fail. 2016 Apr;4(4):299-300. - PMID 27033017 Citation Status MEDLINE |
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| doi: |
10.1016/j.jchf.2015.12.017 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM258363894 |
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| 100 | 1 | |a Pulignano, Giovanni |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Incremental Value of Gait Speed in Predicting Prognosis of Older Adults With Heart Failure |b Insights From the IMAGE-HF Study |
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| 500 | |a Date Completed 10.01.2017 | ||
| 500 | |a Date Revised 08.04.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a CommentIn: JACC Heart Fail. 2016 Apr;4(4):299-300. - PMID 27033017 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a OBJECTIVES: The aim of this study was to assess the relationship between gait speed and the risk for death and/or hospital admission in older patients with heart failure (HF) | ||
| 520 | |a BACKGROUND: Gait speed is a reliable single marker of frailty in older people and can predict falls, disability, hospital admissions, and mortality | ||
| 520 | |a METHODS: In total, 331 community-living patients ≥70 years of age (mean age 78 ± 6 years, 43% women, mean ejection fraction 35 ± 11%, mean New York Heart Association functional class 2.7 ± 0.6) in stable condition and receiving optimized therapy for chronic HF were prospectively enrolled and followed for 1 year. Gait speed was measured at the usual pace over 4 m, and cutoffs were defined by tertiles: ≤0.65, 0.66 to 0.99, and ≥1.0 m/s | ||
| 520 | |a RESULTS: There was a significant association between gait speed tertiles and 1-year mortality: 38.3%, 21.9%, and 9.1% (p < 0.001), respectively. On multivariate analysis, gait speed was associated with a lower risk for all-cause death (hazard ratio: 0.62; 95% confidence interval: 0.43 to 0.88) independently of age, ejection fraction <20%, systolic blood pressure, anemia, and absence of beta-blocker therapy. Gait speed was also associated with a lower risk for hospitalization for HF and all-cause hospitalization. When gait speed was added to the multiparametric Cardiac and Comorbid Conditions Heart Failure risk score, it improved the accuracy of risk stratification for all-cause death (net reclassification improvement 0.49; 95% confidence interval: 0.26 to 0.73, p < 0.001) and HF admissions (net reclassification improvement 0.37; 95% confidence interval: 0.15 to 0.58; p < 0.001) | ||
| 520 | |a CONCLUSIONS: Gait speed is independently associated with death, hospitalization for HF, and all-cause hospitalization and improves risk stratification in older patients with HF evaluated using the Cardiac and Comorbid Conditions Heart Failure score. Assessment of frailty using gait speed is simple and should be part of the clinical evaluation process | ||
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| 650 | 4 | |a hospitalization | |
| 650 | 4 | |a prognosis | |
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| 700 | 1 | |a Di Lenarda, Andrea |e verfasserin |4 aut | |
| 700 | 1 | |a Alunni, Gianfranco |e verfasserin |4 aut | |
| 700 | 1 | |a Senni, Michele |e verfasserin |4 aut | |
| 700 | 1 | |a Tarantini, Luigi |e verfasserin |4 aut | |
| 700 | 1 | |a Cioffi, Giovanni |e verfasserin |4 aut | |
| 700 | 1 | |a Tinti, Maria Denitza |e verfasserin |4 aut | |
| 700 | 1 | |a Barbati, Giulia |e verfasserin |4 aut | |
| 700 | 1 | |a Minardi, Giovanni |e verfasserin |4 aut | |
| 700 | 1 | |a Uguccioni, Massimo |e verfasserin |4 aut | |
| 700 | 0 | |a IMAGE-HF Study Investigators |e verfasserin |4 aut | |
| 700 | 1 | |a Gaschino, Giovanni |e investigator |4 oth | |
| 700 | 1 | |a Tarantini, Luigi |e investigator |4 oth | |
| 700 | 1 | |a Cioffi, Giovanni |e investigator |4 oth | |
| 700 | 1 | |a Di Lenarda, Andrea |e investigator |4 oth | |
| 700 | 1 | |a Russo, Giulia |e investigator |4 oth | |
| 700 | 1 | |a Radini, Donatella |e investigator |4 oth | |
| 700 | 1 | |a Stellato, Kira |e investigator |4 oth | |
| 700 | 1 | |a Senni, Michele |e investigator |4 oth | |
| 700 | 1 | |a Alunni, Gianfranco |e investigator |4 oth | |
| 700 | 1 | |a Murrone, Adriano |e investigator |4 oth | |
| 700 | 1 | |a Zuchi, Cinzia |e investigator |4 oth | |
| 700 | 1 | |a Pulignano, Giovanni |e investigator |4 oth | |
| 700 | 1 | |a Del Sindaco, Donatella |e investigator |4 oth | |
| 700 | 1 | |a Tolone, Stefano |e investigator |4 oth | |
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