A reduced gait speed is independently associated with an increased risk of cardiovascular mortality or heart failure exacerbation in patients with stable chronic heart failure, while muscle strength and mass do not exhibit a similar correlation.
A prospective cohort study conducted between 2016 and 2018 aimed to evaluate the relationship between gait speed, grip strength, appendicular skeletal muscle index, and cardiovascular outcomes. The study included 205 patients (mean age: 66 years; 22% women) diagnosed with stable chronic heart failure, characterized by a left ventricular ejection fraction (LVEF) below 40% or 50% at the time of enrollment. Researchers assessed physical performance using gait speed (m/s), grip strength (kg), and appendicular muscle index (kg/m²).
Findings demonstrated that patients with a gait speed below 0.8 m/s faced a significantly higher risk of cardiovascular mortality or heart failure exacerbation over a median follow-up period of 4.7 years. The adjusted hazard ratio for each 0.1 m/s increase in gait speed was 0.81 (95% CI, 0.68-0.95; P < 0.017). Notably, grip strength and appendicular muscle index did not significantly impact the primary composite outcome, with consistent results across all clinical subgroups, regardless of gender, comorbidities, and biomarker levels.
The authors emphasized the importance of assessing muscle function related to mobility rather than solely focusing on muscle strength and mass. They concluded that “differential analysis of multiple muscle parameters in a single cohort may provide useful evidence to identify the clinically most important ones.” This suggests that gait speed assessment should be integrated into routine clinical evaluation for a more accurate prognosis in heart failure patients.
The study’s limitations include the exclusive use of specific muscle performance tests, potentially overlooking other relevant functional assessments. Additionally, the cohort consisted only of Caucasian patients, primarily with reduced LVEF, which may limit the generalizability of the findings to other ethnic groups and individuals with preserved ejection fraction.
The research, led by Vladimir Cheik, MD, at the Centre for Complex Heart Failure, University Hospital of Würzburg, was published in ESC Heart Failure on February 4, 2025.
This article is for informational purposes only and should not replace professional medical advice.
