Aim Patients with heart failure (HF) frequently experience decreased physical function, including walking speed. Slower walking speed is associated with poorer prognosis. However, most of these reports focused on patients with stable HF, and the relationship between walking speed in acute phase and clinical outcomes is unclear. Therefore, we aimed to investigate the associations between walking speed early after admission and clinical events in patients with acute decompensated HF (ADHF). Methods and Results We reviewed consecutive 1391 patients admitted due to ADHF. We measured walking speed the first time to walk on the ward more than 10 m after admission, and the speed within four days after admission was included in this study. The primary outcome was combined events (all-cause death and/or readmission due to HF). The follow-up period was up to one year from the discharge. The study population had a median age of 74 years (interquartile range [IQR]: 65–80 years), and 35.9% of patients were females. The median walking speed was 0.70 m/s (IQR: 0.54–0.88 m/s). Combined events occurred in 429 (30.8%) patients. Faster walking speed was independently associated with lower rate of combined events (adjusted hazard ratio per 0.1 m/s increasing: 0.951, 95% confidence interval:0.912–0.992). Conclusion Faster walking speed within four days after admission was associated with favourable clinical outcomes in patients with ADHF. The results suggest that measuring walking speed in acute phase is useful for earlier risk stratification.

中文翻译：

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急性失代偿性心力衰竭患者入院后早期步行速度与全因死亡和/或再入院之间的关联

目标 心力衰竭 (HF) 患者经常会出现身体功能下降，包括步行速度下降。步行速度较慢与预后较差相关。然而，这些报告大多集中于稳定型心力衰竭患者，急性期步行速度与临床结果之间的关系尚不清楚。因此，我们的目的是调查急性失代偿性心力衰竭（ADHF）患者入院后早期步行速度与临床事件之间的关联。方法和结果 我们连续回顾了 1391 名因 ADHF 入院的患者。我们测量了入院后第一次在病房内行走超过10 m的步行速度，入院后四天内的速度纳入本研究。主要结局是合并事件（全因死亡和/或心力衰竭导致的再入院）。随访期为出院后一年。研究人群的中位年龄为 74 岁（四分位距 [IQR]：65-80 岁），35.9% 的患者为女性。中位步行速度为 0.70 m/s（IQR：0.54–0.88 m/s）。429 名 (30.8%) 患者发生了联合事件。更快的步行速度与较低的组合事件发生率独立相关（每增加 0.1 m/s 调整后的风险比：0.951，95% 置信区间：0.912–0.992）。结论 入院后四天内更快的步行速度与 ADHF 患者良好的临床结果相关。结果表明，测量急性期的步行速度有助于早期风险分层。