Forced vital capacity is an independent determinant for decreased activities of daily living in patients with chronic heart failure

Abstract

Purpose: Exercise tolerance is well known to be a limiting factor for activities of daily living (ADL) in patients with chronic heart failure (CHF). Although many studies documented the relationship between forced vital capacity (FVC) and cardiovascular events, it is not evaluated the relationship between respiratory function and ADL in them. The purpose of this study was to investigate whether respiratory function is a limiting factor for the ADL in CHF patients. Methods: We studied 269 patients (194 males) with compensated CHF aged 64.3±14.1 years who underwent a cardiac rehabilitation during the hospitalization. The patients who received a cardiac surgery or had chronic respiratory disease were excluded. We measured pulmonary function, muscle strength and one leg standing time at the hospital discharge. The ADL was evaluated using 10-meter comfortable walking speed at discharge and the performance measure for activities of daily living-8 (PMADL-8) 2 weeks after discharge. The PM ADL-8 was used to assess the difficulty in performing specified daily physical activities. To evaluate limiting factors for the ADL, the stepwise multiple regression analysis was performed using indices of respiratory and motor function as predictive variables. Results: The PMADL-8 showed significant univariate correlations to age (r=0.376), FVC (r=-0.507), forced expiratory volume in 1 second (r=-0.495) maximal inspiratory pressure (r=-0.365), maximal expiratory pressure (r=-0.364) quadriceps strength (r=-0.410), one leg standing time (r=-0.341) and 10-meter walking speed (r=-0.581) (p<0.001, respectively). The result of the stepwise multiple regression analysis was shown in Table. The FVC and one leg standing time were detected as significant and independent predictors for the decreased ADL. (Tabel Presented) Conclusion: The FVC was identified as an independent strong determinant for decreased ADL in patients with CHF.