Poor Medication Adherence Is Associated With Worse Health Status In Heart Failure With Reduced Ejection Fraction
HFSA ePoster Library. Mohammed M. 09/10/21; 343546; 306
Dr. Moghniuddin Mohammed
REGULAR CONTENT
Login now to access Regular content available to all registered users.
Abstract
Discussion Forum (0)
Introduction In patients with heart failure with preserved ejection fraction (HFpEF), the components of cardiorespiratory fitness (CRF) in the presence or absence of comorbid obstructive sleep apnea (OSA) are underexplored. We sought to profile the exercise limitations related to this comorbidity in a database of patients with HFpEF who had undergone maximal cardiopulmonary exercise testing (CPET).
Methods Fifty patients with New York Heart Association class II-III HFpEF (left ventricular ejection fraction (LVEF) >50%) underwent maximal CPET to collect peak oxygen consumption (VO2), expressed in absolute values, percent (%) predicted, and relative to body weight and exercise time. Echocardiography was performed to obtain LVEF, diastolic function (e’) and LV filling pressure (E/e’). The International Physical Activity Questionnaire (IPAQ) was used to estimate physical activity. Differences between patients with and without OSA were examined with the Mann-Whitney U and/or Chi-Square test. Significance was defined as P<0.05 with results displayed as number (%) or median (interquartile range; IQR).
Results Patients with OSA were younger, more likely to be Black and less physically active than those without OSA (Table 1), while BMI was higher in participants with OSA (Figure 1). The %-predicted peak VO2 was lower in those with OSA (Figure 1), with similar trends in %-predicted absolute VO2 and exercise time (Table 1). There was no difference in LVEF, e’ or E/e’ between groups.
Conclusions In a database of patients with HFpEF who underwent CPET, those with comorbid OSA had worse %-predicted peak VO2 values. This was in the context of higher BMI and lower physical activity but no discernable differences in cardiac function. Future prospective trials aimed at studying the effects of weight loss and/or increasing physical activity on CRF are warranted in patients with OSA and HFpEF to improve CRF.
Methods Fifty patients with New York Heart Association class II-III HFpEF (left ventricular ejection fraction (LVEF) >50%) underwent maximal CPET to collect peak oxygen consumption (VO2), expressed in absolute values, percent (%) predicted, and relative to body weight and exercise time. Echocardiography was performed to obtain LVEF, diastolic function (e’) and LV filling pressure (E/e’). The International Physical Activity Questionnaire (IPAQ) was used to estimate physical activity. Differences between patients with and without OSA were examined with the Mann-Whitney U and/or Chi-Square test. Significance was defined as P<0.05 with results displayed as number (%) or median (interquartile range; IQR).
Results Patients with OSA were younger, more likely to be Black and less physically active than those without OSA (Table 1), while BMI was higher in participants with OSA (Figure 1). The %-predicted peak VO2 was lower in those with OSA (Figure 1), with similar trends in %-predicted absolute VO2 and exercise time (Table 1). There was no difference in LVEF, e’ or E/e’ between groups.
Conclusions In a database of patients with HFpEF who underwent CPET, those with comorbid OSA had worse %-predicted peak VO2 values. This was in the context of higher BMI and lower physical activity but no discernable differences in cardiac function. Future prospective trials aimed at studying the effects of weight loss and/or increasing physical activity on CRF are warranted in patients with OSA and HFpEF to improve CRF.
| Non OSA (n=22) | OSA (n=28) | P-Value | |
| Age, yr | 59 (54-64) | 51 (44-62) | 0.010 |
| Black | 7 (32%) | 20 (71%) | 0.010 |
| Female | 18 (82%) | 18 (64%) | 0.215 |
| IPAQ, MET minutes/week | 1813 (813-10344) | 235 (114-727) | 0.007 |
| BMI, kg/m2 | 38.2 (33.8-42.3) | 44.2 (37.3-49.3) | 0.004 |
| Absolute Peak VO2, L | 1.54 (1.33-1.83) | 1.75 (1.36-2.24) | 0.305 |
| % Predicted Absolute Peak VO2 | 87 (72-102) | 74 (68-84) | 0.061 |
| Peak VO2, mL•kg-1•min-1 | 15.0 (13.3-17.9) | 13.9 (11.5-17.8) | 0.287 |
| % Predicted Relative Peak VO2 | 64 (50-78) | 50 (42-63) | 0.005 |
| Exercise Time, sec | 562 (487-647) | 480 (340-628) | 0.074 |
| LVEF, % | 61 (55-62) | 58 (55-63) | 0.714 |
| e', cm/sec | 8.2 (5.9-10.2) | 8.3 (6.1-10.0) | 0.837 |
| E/e' | 10.9 (8.4-14.2) | 9.5 (8.1-12.3) | 0.377 |
Introduction In patients with heart failure with preserved ejection fraction (HFpEF), the components of cardiorespiratory fitness (CRF) in the presence or absence of comorbid obstructive sleep apnea (OSA) are underexplored. We sought to profile the exercise limitations related to this comorbidity in a database of patients with HFpEF who had undergone maximal cardiopulmonary exercise testing (CPET).
Methods Fifty patients with New York Heart Association class II-III HFpEF (left ventricular ejection fraction (LVEF) >50%) underwent maximal CPET to collect peak oxygen consumption (VO2), expressed in absolute values, percent (%) predicted, and relative to body weight and exercise time. Echocardiography was performed to obtain LVEF, diastolic function (e’) and LV filling pressure (E/e’). The International Physical Activity Questionnaire (IPAQ) was used to estimate physical activity. Differences between patients with and without OSA were examined with the Mann-Whitney U and/or Chi-Square test. Significance was defined as P<0.05 with results displayed as number (%) or median (interquartile range; IQR).
Results Patients with OSA were younger, more likely to be Black and less physically active than those without OSA (Table 1), while BMI was higher in participants with OSA (Figure 1). The %-predicted peak VO2 was lower in those with OSA (Figure 1), with similar trends in %-predicted absolute VO2 and exercise time (Table 1). There was no difference in LVEF, e’ or E/e’ between groups.
Conclusions In a database of patients with HFpEF who underwent CPET, those with comorbid OSA had worse %-predicted peak VO2 values. This was in the context of higher BMI and lower physical activity but no discernable differences in cardiac function. Future prospective trials aimed at studying the effects of weight loss and/or increasing physical activity on CRF are warranted in patients with OSA and HFpEF to improve CRF.
Methods Fifty patients with New York Heart Association class II-III HFpEF (left ventricular ejection fraction (LVEF) >50%) underwent maximal CPET to collect peak oxygen consumption (VO2), expressed in absolute values, percent (%) predicted, and relative to body weight and exercise time. Echocardiography was performed to obtain LVEF, diastolic function (e’) and LV filling pressure (E/e’). The International Physical Activity Questionnaire (IPAQ) was used to estimate physical activity. Differences between patients with and without OSA were examined with the Mann-Whitney U and/or Chi-Square test. Significance was defined as P<0.05 with results displayed as number (%) or median (interquartile range; IQR).
Results Patients with OSA were younger, more likely to be Black and less physically active than those without OSA (Table 1), while BMI was higher in participants with OSA (Figure 1). The %-predicted peak VO2 was lower in those with OSA (Figure 1), with similar trends in %-predicted absolute VO2 and exercise time (Table 1). There was no difference in LVEF, e’ or E/e’ between groups.
Conclusions In a database of patients with HFpEF who underwent CPET, those with comorbid OSA had worse %-predicted peak VO2 values. This was in the context of higher BMI and lower physical activity but no discernable differences in cardiac function. Future prospective trials aimed at studying the effects of weight loss and/or increasing physical activity on CRF are warranted in patients with OSA and HFpEF to improve CRF.
| Non OSA (n=22) | OSA (n=28) | P-Value | |
| Age, yr | 59 (54-64) | 51 (44-62) | 0.010 |
| Black | 7 (32%) | 20 (71%) | 0.010 |
| Female | 18 (82%) | 18 (64%) | 0.215 |
| IPAQ, MET minutes/week | 1813 (813-10344) | 235 (114-727) | 0.007 |
| BMI, kg/m2 | 38.2 (33.8-42.3) | 44.2 (37.3-49.3) | 0.004 |
| Absolute Peak VO2, L | 1.54 (1.33-1.83) | 1.75 (1.36-2.24) | 0.305 |
| % Predicted Absolute Peak VO2 | 87 (72-102) | 74 (68-84) | 0.061 |
| Peak VO2, mL•kg-1•min-1 | 15.0 (13.3-17.9) | 13.9 (11.5-17.8) | 0.287 |
| % Predicted Relative Peak VO2 | 64 (50-78) | 50 (42-63) | 0.005 |
| Exercise Time, sec | 562 (487-647) | 480 (340-628) | 0.074 |
| LVEF, % | 61 (55-62) | 58 (55-63) | 0.714 |
| e', cm/sec | 8.2 (5.9-10.2) | 8.3 (6.1-10.0) | 0.837 |
| E/e' | 10.9 (8.4-14.2) | 9.5 (8.1-12.3) | 0.377 |
Code of conduct/disclaimer available in General Terms & Conditions
{{ help_message }}
{{filter}}