Heart failure & cardiomyopathiesSecondary analysis
Distinct Impact of Noncardiac Comorbidities on Exercise Capacity and Functional Status in Chronic Heart Failure
- Secondary analysis of pooled randomised trials (HF-ACTION, IRONOUT-HF, NEAT-HFpEF, INDIE-HFpEF, RELAX-HFpEF)
- cluster analysis
Authors' conclusion
NCC type and burden have a significant and cumulative effect on exercise capacity, occur in clusters, and are associated with clinical outcomes in patients with chronic HF.
Study context
- Population
- Patients with chronic heart failure (HF) (reduced or preserved EF) in 5 trials
- Participants
- 2,777 patients
- Comparison
- NCC clusters and NCC burden
- Primary endpoint
- Peak Vo2, 6MWT, KCCQ and all-cause death by NCC status
Primary result
As reported in the abstract
Hazard ratio
1.60
95% CI 1.25–2.04
P < 0.001
Cluster 2 vs Cluster 1
HR 1.60 (95% CI 1.25–2.04); P < 0.001
Further findings
Median
| Outcome | HF with preserved ejection fraction | reduced ejection fraction | P value |
|---|---|---|---|
| NCC burden by HF type · baseline | 3 (IQR 2–4) | 2 (IQR 1–3) | P < 0.001 |
Obesity and exercise capacity in HFpEF
- Obesity played a more important role in HFpEF in limiting peak Vo2 and 6MWT
Response to aerobic exercise training (peak Vo2), Cluster 3
- Diminished response to aerobic exercise training in Cluster 3
- P for interaction = 0.045
Original publication
Distinct Impact of Noncardiac Comorbidities on Exercise Capacity and Functional Status in Chronic Heart Failure. JACC Heart Fail. Published 28 June 2023. doi:10.1016/j.jchf.2023.05.018
Summarised from the published abstract; every number is checked against it