Cardio-renal Anaemia Syndrome is an Independent Risk Factor for Death in Patients with Heart Failure with Reduced Ejection Fraction

Abstract Objective The purpose of this retrospective study is to evaluate the effectiveness of early cardiac rehabilitation on patients with heart failure following acute myocardial infarction. Methods Two hundred and thirty-two patients who developed heart failure following acute myocardial infarction were enrolled in this study. Patients were divided into heart failure with reduced ejection fraction group (n = 54) and heart failure with mid-range ejection fraction group (n = 178). Seventy-eight patients who accepted a two-week cardiac rehabilitation were further divided into two subgroups based on major adverse cardiovascular events. Key cardio-pulmonary exercise testing indicators that may affect the prognosis were identified among the cardiac rehabilitation patients. Results Early cardiac rehabilitation significantly reduced cardiac death and re-hospitalization in patients. There was more incidence of diabetes, hyperkalemia and low PETCO2 in the cardiac rehabilitation group who developed re-hospitalization. Low PETCO2 at anaerobic threshold (≤ 33.5 mmHg) was an independent risk factor for re-hospitalization. Conclusions Early cardiac rehabilitation reduced major cardiac events in patients with heart failure following acute myocardial infarction. The lower PETCO2 at anaerobic threshold is an independent risk factor for re-hospitalization, and could be used as a evaluating hallmark for early cardiac rehabilitation.

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Early cardiac rehabilitation improved prognosis in patients with heart failure following acute myocardial infarction

10.21203/rs.3.rs-36808/v2 ◽

2020 ◽

Author(s):

He Cai ◽

Pengyu Cao ◽

Wanqing Sun ◽

Xinying Zhang ◽

Rongyu Li ◽

...

Keyword(s):

Myocardial Infarction ◽

Heart Failure ◽

Acute Myocardial Infarction ◽

Risk Factor ◽

Ejection Fraction ◽

Cardiac Rehabilitation ◽

Serum Potassium ◽

Independent Risk Factor ◽

Exercise Intolerance ◽

Patients With Heart Failure

Abstract Background: Cardiac rehabilitation (CR) has been shown to improve exercise intolerance and QoL, and minimize re-hospitalizations in patients with congestive heart failure (CHF). However, studies on early CR in patients with acute myocardial infarction (AMI) who developed CHF following percutaneous coronary intervention (PCI) are rare. The purpose of this study is to evaluate the effectiveness of early CR on patients with CHF after AMI following PCI.Methods: Two hundred thirty-seven patients who developed heart failure after AMI following PCI were enrolled. Patients were divided into heart failure with reduced ejection fraction (HFrEF) group (n=55) and heart failure with mid-range ejection fraction (HFmrEF) group (n=182). Of the 237 patients, 78 (22 in HFrEF group and 56 in HFmrEF group) who accepted a two-week CR were further divided into two subgroups based on major adverse cardiovascular events (MACE). Key cardio-pulmonary exercise testing (CPX) variables that may affect the prognosis were identified among the CR patients.Results: Early CR significantly reduced cardiac death in patients with HFrEF (18.2% vs. 60.6%, P=0.02), and reduced re-hospitalization in patients with HFmrEF after AMI (3.6% vs. 21.4%, P=0.02). Serum potassium and CR ratio were independent risk factors for MACE in patients with both HFrEF and HFmrEF after AMI. In the CR group who developed MACE, there were more diabetics (22.2% vs. 66.7%, P=0.035), with higher serum potassium (3.96mmol/l vs. 4.31mmol/l, P=0.043), and lower PETCO2 at ventilatory threshold (VT) (P=0.016). PETCO2 at VT was an independent risk factor for re-hospitalization. The incidence of re-hospitalization was significantly lower when the PETCO2 at VT was greater than 33.5mmHg (0(0.00% vs. 6(13.64%), P=0.03).Conclusions: Early CR reduced the incidence of MACE in patients with heart failure after AMI following PCI. The PETCO2 at VT is an independent risk factor for re-hospitalization, and could be used as a key evaluating hallmark for early CR in patients who developed heart failure after AMI.

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Early Cardiac Rehabilitation Improved Prognosis in Patients with Heart Failure Following Acute Myocardial Infarction

10.21203/rs.3.rs-36808/v1 ◽

2020 ◽

Author(s):

He Cai ◽

Pengyu Cao ◽

Wanqing Sun ◽

Xinying Zhang ◽

Rongyu Li ◽

...

Keyword(s):

Myocardial Infarction ◽

Heart Failure ◽

Acute Myocardial Infarction ◽

Risk Factor ◽

Ejection Fraction ◽

Cardiac Rehabilitation ◽

Serum Potassium ◽

Independent Risk Factor ◽

Exercise Intolerance ◽

Patients With Heart Failure

Abstract Background: Cardiac rehabilitation (CR) has been shown to improve exercise intolerance and QoL, and minimize re-hospitalizations in patients with congestive heart failure (CHF). However, studies on early CR in patients with acute myocardial infarction (AMI) who developed CHF following percutaneous coronary intervention (PCI) are rare. The purpose of this study is to evaluate the effectiveness of early CR on patients with CHF after AMI following PCI.Methods: Two hundred thirty-seven patients who developed heart failure after AMI following PCI were enrolled. Patients were divided into heart failure with reduced ejection fraction (HFrEF) group and heart failure with mid-range ejection fraction (HFmrEF) group. Of which, 78 patients who accepted a two-week CR were further divided into two subgroups based on major adverse cardiovascular events (MACE). Key cardio-pulmonary exercise testing (CPX) variables that may affect the prognosis were identified through the comparison of the cardio-respiratory fitness (CRF).Results: Early CR significantly reduced cardiac death in patients with HFrEF, and reduced re-hospitalization in patients with HFmrEF after AMI (P <0.01). Serum potassium and CR ratio were independent risk factors for MACE in patients with both HFrEF and HFmrEF after AMI. In the CR group who developed MACE, there were more diabetics (P=0.035), with higher serum potassium (P=0.043), and lower PETCO2 at VT (P=0.016). PETCO2 at VT was an independent risk factor for re-hospitalization. The incidence of re-hospitalization was significantly lower when the PETCO2 at VT was greater than 33.5mmHg (P=0.03).Conclusions: Early CR reduced the incidence of MACE in patients with heart failure after AMI following PCI. The PETCO2 at VT is an independent risk factor for re-hospitalization, and could be used as a key evaluating hallmark for early CR in patients who developed heart failure after AMI.

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