Valvular & structural heart disease

Disentangling Heart Failure and Physical Frailty: Prospective Study of Patients Undergoing Percutaneous Mitral Valve Repair

JACC Heart FailPublished Prospective cohort study

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
Methodological detailsconsecutive patients, before-after
  • Consecutive patients
  • Before-after

Main finding

As reported in the abstract

Frailty prevalence

P < 0.001

Observational data: associations, not effects.

Further findings

OutcomeHR (95% CI)
Mortality by frailty dynamicsNew frailtyvs Persistently nonfrail1.41 (0.41–4.86)
Mortality by frailty dynamicsReversal of frailtyvs Persistently nonfrail2.17 (1.03–4.57)
Mortality by frailty dynamicsPersistently frailvs Persistently nonfrail3.26 (1.62–6.57)
  • 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: Prospective Study of Patients Undergoing Percutaneous Mitral Valve Repair. JACC Heart Fail. Published 24 May 2023. doi:10.1016/j.jchf.2023.04.011

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