Gait Speed Key Predictor of Heart Failure Outcomes

TOPLINE:

Slower gait speed is independently associated with an increased risk for cardiovascular death or worsening heart failure in patients with stable heart failure with reduced or improved left ventricular ejection fraction, whereas parameters of muscle strength and mass such as handgrip strength and appendicular skeletal muscle index were not linked to changes in outcomes.

METHODOLOGY:

• Researchers examined the prognostic impact of gait speed, handgrip strength, and appendicular skeletal muscle index on cardiovascular outcomes in patients with stable chronic heart failure.
• They conducted a prospective cohort study (2016-2018) of 205 adult patients (median age, 66 years; 22% women) with stable chronic heart failure who were previously diagnosed with overtly reduced left ventricular ejection fraction (LVEF) below 40% and LVEF below 50% at enrollment.
• Gait speed was measured in m/s, maximal handgrip strength was assessed in kg, and appendicular skeletal muscle index was measured in kg/m².
• Low physical performance was defined as having a gait speed of 0.8 m/s of slower, low muscle strength as having maximal handgrip strength below 27 kg for men and less than 16 kg for women, and low muscle mass as having an appendicular skeletal muscle index below 7.0 kg/m² for men and under 5.5 kg/m² for women.
• The primary combined outcome was defined as cardiovascular death or worsening heart failure over a median follow-up of 4.7 years.

TAKEAWAY:

• Slower gait speed was independently associated with an increased risk for cardiovascular death or worsening heart failure (adjusted subdistribution hazard ratio per 0.1 m/s increase, 0.81; 95% CI, 0.68-0.95; P
• Handgrip strength and appendicular skeletal muscle index showed no significant association with the primary outcome.
• The associations remained consistent across key clinical subgroups stratified by gender, comorbidities, and organ function biomarkers.

IN PRACTICE:

“A differentiated analysis of multiple muscle parameters within a single cohort can provide useful evidence to identify which are clinically most important,” the authors of the study wrote. “Evaluating muscular function with respect to locomotion for the risk assessment of adverse CV [cardiovascular] outcomes seems more important than the evaluation of muscle strength and mass,” they added.

SOURCE:

This study was led by Vladimir Cejka, MD, of the Comprehensive Heart Failure Center at the University Hospital Wü rzburg in Germany. It was published online on February 4, 2025, in ESC Heart Failure.

LIMITATIONS:

The findings were confined to the muscle parameters assessed in this work while alternative tests exist to evaluate physical performance and muscle strength and quantity. This study included only Caucasian participants with predominantly reduced left ventricular ejection fraction. Therefore, the applicability of the findings to other ethnic groups and to patients with heart failure with preserved ejection fraction was uncertain.

DISCLOSURES:

The authors declared no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.