Valvular & structural heart diseaseCohort study
Disentangling Heart Failure and Physical Frailty
- Prospective cohort study
- consecutive patients
- before-after
Authors' conclusion
Treatment of mitral regurgitation in patients with heart failure is associated with almost a halved burden of physical frailty, particularly in patients with a less advanced phenotype.
Study context
- Population
- Patients with HF undergoing percutaneous mitral valve repair (PMVR)
- Participants
- 258 patients
- Exposure
- Frailty before vs 6 weeks after PMVR
- Outcome
- Frailty by Fried criteria (weight loss, weakness, exhaustion, slowness, low activity)
- Follow-up
- Before and 6 weeks after PMVR
Main finding
As reported in the abstract
Frailty prevalence
P < 0.001
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| Mortality by frailty dynamics — New frailty vs Persistently nonfrail | 1.41 (0.41–4.86) | |
| Mortality by frailty dynamics — Reversal of frailty vs Persistently nonfrail | 2.17 (1.03–4.57) | |
| Mortality by frailty dynamics — Persistently frail vs Persistently nonfrail | 3.26 (1.62–6.57) | |
| 0.10.31310Hazard ratio (log scale) |
- Mortality by frailty dynamics: P = 0.006 for trend
Frailty domains
- Slowness, exhaustion and inactivity significantly decreased; weakness unchanged
Associations of frailty
- Baseline frailty associated with comorbidities, NT-proBNP and functional capacity; frailty after PMVR not associated with NT-proBNP
- Predictors of reversibility: NYHA class <IV, absence of weakness, lower frailty score
Original publication
Disentangling Heart Failure and Physical Frailty. JACC Heart Fail. Published 24 May 2023. doi:10.1016/j.jchf.2023.04.011
Summarised from the published abstract; every number is checked against it