부산대학교 도서관

Keywords: exercise training; frailty; heart failure; physical activity Abstract Background/Objectives Frailty is common in people with heart failure (HF) and associated with poorer outcomes. The aim of this study was to describe the characteristics, exercise participation, and outcomes of frail and not-frail participants enrolled in a randomized trial of exercise training (ET) within a cardiac rehabilitation (CR) program. Design Secondary analysis of EJECTION-HF randomized trial (ACTRN12608000263392). Setting Five HF-specific CR programs in Queensland, Australia. Participants Adults recently hospitalized with HF. Intervention All participated in CR including home exercise prescription and monitoring; half were randomized to center-based ET. Measurements A frailty index (FI) was constructed at randomization and 6-month follow-up. Outcomes included ET attendance, change in 6-min walk distance (6MWD), improved FI (>0.09units) at 6 months, achieving physical activity (PA) guidelines at 6 months, and 12month all-cause death or readmission. Results The FI was measured in 256 participants at randomization: 110 (43%) were not-frail (FI 0.2 or less), 119 (46%) were frail (FI >0.2 to 0.39), and 27 (11%) were very frail (FI â¥0.4). Frailty was more common with older age, female gender, decompensated HF, worse HF symptoms, and preserved ejection fraction. ET attendance did not differ by frailty group. Participants who were more frail had lower 6WMD at enrollment, but similar improvement over 6 months. Mean FI improved by 0.03units at 6 months (95% CI 0.02-0.04, p Conclusion Frail people with HF participating in CR that includes home and/or center-based ET often achieve PA guidelines, and some may have meaningful reductions in frailty. Article Note: See related editorial by Pandeyetal in this issue. Funding information National Health and Medical Research Council, Grant/Award Number: 498403; National Heart Foundation of Australia, Grant/Award Number: Post graduate scholarship; Royal Brisbane and Women's Hospital Foundation, Grant/Award Number: Patricia Dukes Fellowship; The Prince Charles Hospital Foundation, Grant/Award Number: TPCH Foundation grant CAPTION(S): Table S1: Scoring of items used to create frailty index Table S2: Presence of deficits (item score = 1) according to frailty group Figure S1: Flow diagram of available data at baseline and follow-up for participants with a frailty score calculated. Figure S2: Mean 6-min walk distance over time according to frailty status and randomization group. There was no statistically significant interaction between intervention group and frailty over time (p = 0.079) for estimated marginal means for 6MWD at baseline, month 3, and month 6. Gains at month 3 for those who were very frail by appeared to be attenuated by 6 months. Byline: Alison M. Mudge, Anita Pelecanos, Julie A. Adsett