Impact of reduced kidney function on cardiopulmonary fitness in patients with systolic heart failure.

摘要

BACKGROUND: Decreased renal function has been consistently associated with increased mortality among patients with systolic heart failure. The relationship between estimated glomerular filtration rate (eGFR) and other high-risk features including reduced cardiorespiratory fitness has not been previously reported in this patient population. METHODS: The HF-ACTION trial was a prospective, randomized trial of exercise therapy versus usual care in patients with systolic heart failure. Patients with class 2-4 heart failure and a left ventricular ejection fraction of 75 years, diabetes, and functional class 3-4 symptoms. Conversely, those with an eGFR >90 ml/min/1.73 m(2) had relatively few (1.0) high-risk characteristics. CONCLUSIONS: Reduced renal filtration is associated with impaired cardiorespiratory fitness and a clustering of high-risk features in systolic heart failure patients which portend a more complicated course and higher all-cause mortality.