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  1. Miyahara, So MS
  2. Fujimoto, Naoki MD, PhD
  3. Dohi, Kaoru MD, PhD
  4. Sugiura, Emiyo MD, PhD
  5. Moriwaki, Keishi MD
  6. Omori, Taku MD
  7. Takeuchi, Tetsushiro MD
  8. Kumagai, Naoto MD
  9. Nakamori, Shiro MD, PhD
  10. Yamada, Norikazu MD, PhD
  11. Ito, Masaaki MD, PhD


Purpose: Regular physical activity (PA) is recommended for patients with heart failure (HF). However, the clinical and social characteristics of older HF patients with low-level PA and the impact of light-intensity PA on 6-mo postdischarge adverse cardiovascular events are still unclear.


Methods: Forty-one older patients who had been admitted because of decompensated HF (American College of Cardiology [ACC]/American Heart Association [AHA] HF classification stage C/D: 76 +/- 5 y) were prospectively enrolled. Light-intensity (1.5-2.9 metabolic equivalents [METs]) and moderate-intensity (>=3 METs) PAs were determined by triaxial accelerometry for at least 7 d postdischarge. Six-min walk distance and 36-item Short Form questionnaire (SF-36) score were evaluated at discharge. HF patients were stratified into either the HFPA-high or HFPA-low group according to median daily PA. Twenty-nine older ACC/AHA stage A/B outpatients (HF-risk), who were at risk for HF but no symptoms of HF had developed, also completed these assessments. Clinical predictors for 6-mo postdischarge HF rehospitalization were assessed.


Results: HF patients were anemic and less active. HFPA-low patients were less likely to engage in household work, took fewer steps, and had less light and moderate-intensity PA than HFPA-high patients. There were no differences in 6-min walk distance, SF-36 score, or left ventricular ejection fraction between HFPA-low and HFPA-high patients. Postdischarge PA, especially light-intensity PA, was independently associated with HF rehospitalization.


Conclusion: Low volume of PA postdischarge, especially at 1.5 to 2.9 METs, predicts 6-mo postdischarge HF rehospitalization in older HF patients.