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Meta-Analysis
. 2020 Dec 9;20(1):512.
doi: 10.1186/s12872-020-01725-5.

Physical functional performance and prognosis in patients with heart failure: a systematic review and meta-analysis

Iván José Fuentes-Abolafio  1 , Brendon Stubbs  2   3   4 , Luis Miguel Pérez-Belmonte  5   6   7 , María Rosa Bernal-López  5   8 , Ricardo Gómez-Huelgas  5   8 , Antonio Ignacio Cuesta-Vargas  9   10
Affiliations
Meta-Analysis

Physical functional performance and prognosis in patients with heart failure: a systematic review and meta-analysis

Iván José Fuentes-Abolafio et al. BMC Cardiovasc Disord. .

Abstract

Background: Patients with Heart Failure (HF) show impaired functional capacities which have been related to their prognosis. Moreover, physical functional performance in functional tests has also been related to the prognosis in patients with HF. Thus, it would be useful to investigate how physical functional performance in functional tests could determine the prognosis in patients with HF, because HF is the leading cause of hospital admissions for people older than 65 years old. This systematic review and meta-analysis aims to summarise and synthesise the evidence published about the relationship between physical functional performance and prognosis in patients with HF, as well as assess the risk of bias of included studies and the level of evidence per outcome.

Methods: Major electronic databases, such as PubMed, AMED, CINAHL, EMBASE, PEDro, Web of Science, were searched from inception to March 2020 for observational longitudinal cohort studies (prospective or retrospective) examining the relationship between physical functional performance and prognosis in patients with HF.

Results: 44 observational longitudinal cohort studies with a total of 22,598 patients with HF were included. 26 included studies reported a low risk of bias, and 17 included studies showed a moderate risk of bias. Patients with poor physical functional performance in the Six Minute Walking Test (6MWT), in the Short Physical Performance Battery (SPPB) and in the Gait Speed Test showed worse prognosis in terms of larger risk of hospitalisation or mortality than patients with good physical functional performance. However, there was a lack of homogeneity regarding which cut-off points should be used to stratify patients with poor physical functional performance from patients with good physical functional performance.

Conclusion: The review includes a large number of studies which show a strong relationship between physical functional performance and prognosis in patients with HF. Most of the included studies reported a low risk of bias, and GRADE criteria showed a low and a moderate level of evidence per outcome.

Keywords: Functional tests; Heart failure; Hospitalisation; Mortality; Physical functional performance; Prognosis.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Flow-Diagram. PRISMA 2009. From: Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMA Group (2009). Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Med 6(6): e1000097. doi:10.1371/journal.pmed1000097. For more information, visit www.prisma-statement.org
Fig. 2
Fig. 2
Forest Plots ilustrating the risk of All-Cause Mortality (a), the risk of HF Mortality (b) and the risk of the combined endpoint of Hospitalisation and Mortality for any cause (c and d) in the 6MWT. Patients with Poor Physical Functional Performance Versus Patients with Good Physical Functional Performance
Fig. 3
Fig. 3
Forest Plot ilustrating the risk of All-Cause Mortality in the Gait Speed Test. Patients with slower Gait Speed Versus Patients with faster Gait Speed
See this image and copyright information in PMC

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