Key result
Cardiorenal syndrome in chronic heart failure is linked to an absolute ~1.3 mL/kg/min drop in VO2peak.
Why the study?
To investigate the associations of cardiorespiratory fitness with cardiac, vascular, renal, and cardiorenal characteristics in chronic heart failure, and to evaluate the associations of cardiorenal syndrome with the effects of exercise.
Does 3-month telerehabilitation improve peak oxygen consumption in chronic heart failure patients with and without cardiorenal syndrome?
RCT (n=61)
1:1
Does 3-month telerehabilitation improve peak oxygen consumption in chronic heart failure patients with and without cardiorenal syndrome?
Absolute Event Rate: -0.91% vs 0.39%
p-value: p=0.013
Cardiorenal syndrome in chronic heart failure is associated with lower baseline exercise capacity and an attenuated response to telerehabilitation.
Suggests telerehabilitation is a feasible strategy for heart failure management; leaves.
Aims To investigate the associations of cardiorespiratory fitness with cardiac, vascular, renal and cardiorenal characteristics in chronic heart failure in a telerehabilitation randomized clinical trial. Secondly, to evaluate the associations of cardiorenal syndrome with the effects of exercise. Methods and results Sixty-nine heart failure patients attended baseline examination, and 61 patients were randomly assigned 1:1 to 3-month telerehabilitation or control. Data were collected at baseline and 3-month post-intervention, including echocardiography and vascular ultrasound, laboratory tests, exercise test with peak oxygen consumption (VO2peak) measurement and 6-min walk test (6MWT). Baseline VO2peak and 6MWT distance was 0.85 mL*min−1*kg−1 lower and 20 m shorter per 10 mL/min/1.73m2 lower estimated glomerular filtration rate (both P < 0.001). Heart failure patients with cardiorenal syndrome had 3.5 (1.1) mL*min−1*kg−1 lower VO2peak and diastolic dysfunction grade 2–3, and elevated filling pressure was >50% more common compared with those without (all P < 0.05). At the 3-month post-intervention follow-up, only the non-CRS patients in the intervention group increased VO2peak (0.73 (0.51) mL*min−1*kg−1), whereas VO2peak in the CRS subpopulation of controls decreased (−1.34 (0.43) mL*min−1*kg−1). Cardiorenal syndrome was associated with a decrease in VO2peak in CRS patients compared with non-CRS patients, −0.91 (0.31) vs. 0.39 (0.35) mL*min−1*kg−1 respectively, P = 0.013. Conclusions Cardiorenal syndrome was negatively associated with VO2peak and 6MWT distance in chronic HF, and the associations were stronger than for heart failure phenotypes and other characteristics. The effect of exercise was negatively associated with cardiorenal syndrome. Exercise seems to be as important in heart failure patients with cardiorenal syndrome, and future studies should include CRS patients to reveal the most beneficial type of exercise.
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Langlo et al. (2022) conducted an RCT in Chronic heart failure (n=61). Telerehabilitation vs. Control was evaluated on Change in VO2peak (CRS vs non-CRS patients) (p=0.013). In patients with chronic heart failure, cardiorenal syndrome was associated with a decrease in VO2peak compared with non-CRS patients (-0.91 vs. 0.39 mL*min−1*kg−1, P=0.013).
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