HF Patients May Benefit From Increased Physical Activity Level

Patients with heart failure with preserved ejection fraction (HFpEF) who engage in lower levels of physical activity have an increased risk of heart failure (HF) hospitalization and mortality, according to a recent trial.

Although being less physically active is known to increase risk of adverse cardiovascular (CV) events in healthy populations, less is known about how physical activity impacts patients with HFpEF.
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The Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist (TOPCAT) trial assessed the self-reported physical activity levels of 1751 patients with HFpEF in the United States. Participants’ physical activity levels were classified as poor, intermediate, or ideal, according to American Heart Association (AHA) criteria. Median follow-up was 2.4 years.

The researchers used multivariable Cox models to determine the primary composite outcome of HF hospitalization, cardiovascular (CV) mortality, or aborted cardiac arrest.

Demographic information showed that patients’ mean age was 68.6 years.

Overall, 75% of participants met AHA criteria for poor physical activity, while 14% were classified as intermediate and 11% as ideal. A total of 519 patients had experienced the primary composite outcome, with 397 HF hospitalizations, 222 CV deaths, and 6 aborted cardiac arrests.

Poor and intermediate physical activity levels at baseline were associated with a greater risk of HF hospitalization, CV mortality, and all-cause mortality compared with ideal activity levels, after multivariable adjustment for potential confounders.

“In patients with HFpEF, both poor and intermediate self-reported [physical activity] were associated with higher risk of HF hospitalization and mortality,” the researchers concluded.

—Christina Vogt

Reference:

Hegde S, Clagget B, Shah AM, et al. Physical activity and prognosis in the treatment of preserved cardiac function heart failure with an aldosterone antagonist (TOPCAT) trial. 2017;135(25). doi:10.1161/CIRCULATIONAHA.117.028002.