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February 21, 2022Frontiers in Cardiovascular MedicineOpen Access

Physical Inactivity Is Associated With Post-discharge Mortality and Re-hospitalization Risk Among Swedish Heart Failure Patients—The HARVEST-Malmö Study

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Why the study?

The study aimed to evaluate self-reported physical activity as an independent risk factor for post-discharge mortality and re-hospitalization in patients hospitalized for HF, and assess its association with 92 CVD-associated plasma proteins.

Does physical inactivity increase post-discharge mortality and re-hospitalization risk in patients hospitalized for heart failure?

Comparison

Baseline self-reported physical activity levels

Design

Observational cohort study

Follow-up

Median 835 days for death and 157 days for re-hospitalization

Authors

AZAmir ZaghiMalmö UniversityHHHannes HolmLund UniversityJKJohan KordunerSkåne University Hospital

Discussion

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Overview

May refine post-discharge risk assessment in HF but should not yet change practice; leaves open causality and interventional benefit.

Key Points

  • To determine whether self-reported physical inactivity independently predicts post-discharge mortality and re-hospitalization in heart failure patients and to examine its correlation with cardiovascular plasma proteins.
  • Assessed self-reported physical activity via public health survey questionnaires in 434 hospitalized heart failure patients (mean age 75 years; 32% women).
  • Conducted multivariable Cox regression analyses over a median follow-up of 835 days (IQR 390–1,432) for mortality and 157 days (IQR 43–583) for re-hospitalization.
  • Profiled 92 cardiovascular plasma proteins using proximity extension assay in 295 participants with a false discovery rate threshold below 5%.
  • Low weekly physical activity was significantly associated with heightened post-discharge mortality and re-hospitalization risk (p = 0.038) independent of traditional cardiovascular risk factors.
  • Physical inactivity associated significantly with elevated plasma levels of metalloproteinase inhibitor 4, soluble interleukin 1 receptor-like 1, elafin, and transferrin receptor protein 1.
  • The identified elevated plasma proteins are biological mediators implicated in myocardial fibrosis, cell migration, and apoptosis.

Structured PICO

Does physical inactivity increase post-discharge mortality and re-hospitalization risk in patients hospitalized for heart failure?

P
Population
434 patients hospitalized for heart failure, mean age 75 years, 32% women, Swedish cohort (HARVEST-Malmö Study).
I
Intervention
Self-reported physical inactivity (assessed via questionnaires)
C
Comparator
Higher levels of self-reported physical activity
O
Outcome
Post-discharge mortality and re-hospitalizationhard clinical

Self-reported physical inactivity in heart failure patients post-discharge is associated with higher mortality, re-hospitalization, and elevated levels of specific cardiovascular risk proteins.

Cite This Study

Zaghi et al. (2022) studied this question.

synapsesocial.com/papers/6a7ed0c1aff466957bc361dehttps://doi.org/10.3389/fcvm.2022.843029
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Also Consider

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  3. 3Exercise Training and Heart Failure: A Review of the Literature2019 · 57 citations
  4. 4Exercise Training for Heart Failure Patients with and without Systolic Dysfunction: An Evidence-Based Analysis of How Patients Benefit2010 · 42 citations
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