左室駆出率が保持された高齢心不全患者におけるShort Physical Performance Batteryで分類した身体機能に関連する要因の検討

【目的】左室駆出率が保持された心不全（heart failure with preserved ejection fraction：HFpEF）患者の身体機能の違いによる臨床特性および身体機能に関連する因子を明らかにすることである．【方法】2017年11月から2021年10月までに急性増悪で入院した心不全患者310名を対象に，年齢，性別，Body Mass Index（BMI），在院日数，リハビリテーション開始日，New York Heart Association（NYHA）心機能分類，併存疾患，介護保険取得状況，服薬状況，心・腎機能，ヘモグロビン値（Hb），栄養状態，膝伸展筋力，握力，Sh...

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Published in循環器理学療法学 Vol. 1; no. 1; pp. 5 - 18
Main Authors 前田, 聡一郎, 野中, 裕樹, 藤井, 廉, 田中, 慎一郎, 安丸, 直希, 田平, 一行, 木本, 祐太
Format Journal Article
LanguageJapanese
Published 般社団法⼈ 日本循環器理学療法学会 31.03.2022
Subjects
Geriatric Nutritional Risk Index
hear failure with preserved ejection fraction
Short physical Performance Battery
身体機能
高齢心不全
Online AccessGet full text
ISSN2758-0350
DOI10.69168/jcpt.1.1_5

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Abstract 【目的】左室駆出率が保持された心不全（heart failure with preserved ejection fraction：HFpEF）患者の身体機能の違いによる臨床特性および身体機能に関連する因子を明らかにすることである．【方法】2017年11月から2021年10月までに急性増悪で入院した心不全患者310名を対象に，年齢，性別，Body Mass Index（BMI），在院日数，リハビリテーション開始日，New York Heart Association（NYHA）心機能分類，併存疾患，介護保険取得状況，服薬状況，心・腎機能，ヘモグロビン値（Hb），栄養状態，膝伸展筋力，握力，Short Physical Performance Battery（SPPB），Functional Independence Measure（FIM）を調査し，身体機能との関連性を調査した．【結果】包含基準を満たしたHFpEF患者78 名が本研究に参加し，退院時のSPPBスコアに基づいて高身体機能群（10〜12 点：n=25），低身体機能（0〜9 点：n=53）の2群に分類した．ロジスティック回帰分析の結果，独立因子として年齢およびGeriatric Nutritional Risk Index（GNRI）が抽出された．【結論】身体機能が低いHFpEF患者の特性として，高齢で低栄養を呈していることが明らかとなった．
AbstractList 【目的】左室駆出率が保持された心不全（heart failure with preserved ejection fraction：HFpEF）患者の身体機能の違いによる臨床特性および身体機能に関連する因子を明らかにすることである．【方法】2017年11月から2021年10月までに急性増悪で入院した心不全患者310名を対象に，年齢，性別，Body Mass Index（BMI），在院日数，リハビリテーション開始日，New York Heart Association（NYHA）心機能分類，併存疾患，介護保険取得状況，服薬状況，心・腎機能，ヘモグロビン値（Hb），栄養状態，膝伸展筋力，握力，Short Physical Performance Battery（SPPB），Functional Independence Measure（FIM）を調査し，身体機能との関連性を調査した．【結果】包含基準を満たしたHFpEF患者78 名が本研究に参加し，退院時のSPPBスコアに基づいて高身体機能群（10〜12 点：n=25），低身体機能（0〜9 点：n=53）の2群に分類した．ロジスティック回帰分析の結果，独立因子として年齢およびGeriatric Nutritional Risk Index（GNRI）が抽出された．【結論】身体機能が低いHFpEF患者の特性として，高齢で低栄養を呈していることが明らかとなった．
Author 安丸, 直希
前田, 聡一郎
野中, 裕樹
田中, 慎一郎
藤井, 廉
木本, 祐太
田平, 一行
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  fullname: 木本, 祐太
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References_xml – reference: 20) Jack M. Guralnik， Eleanor M. Simonsick， Luigi Ferrucci， et al.: A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol. 1994; 49(2) M85-M94.
– reference: 47) María T. Vidán， Vendula Blaya-Novakova， Elísabet Sánchez， et al.: Prevalence and prognostic impact of frailty and its components in non-dependent elderly patients with heart failure. Eur J Heart Fail. 2016; 18(7) 869-875.
– reference: 25) Yoshinobu Kanda: Investigation of the freely available easy-to-use software ’EZR’ for medical statistics. Bone Marrow Transplant. 2013; 48(3) 452-458.
– reference: 8) Stefan D Anker， Javed Butler， Gerasimos Filippatos， et al.: Empagliflozin in Heart Failure with a Preserved Ejection Fraction. N Engl J Med. 2021;385(16) 1451-1461.
– reference: 5) Miyuki Tsuchihashi-Makaya ， Sanae Hamaguchi， Shintaro Kinugawa et al.: Characteristics andoutcomes of hospitalized patients with heart failure and reduced vs preserved ejection fraction. Report from the Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD). Circ J. 2009; 73 1893-1900.
– reference: 18) 急性・慢性心不全診療ガイドライン（2017年改訂版）https://www.j-circ.or.jp/cms/wp-content/uploads/2017/06/JCS2017_tsutsui_h.pdf（2021年12月20 日引用）
– reference: 39) Tarek Bekfani， Pierpaolo Pellicori， Daniel A Morris， et al.: Sarcopenia in patients with heart failure with preserved ejection fraction: Impact on muscle strength， exercise capacity and quality of life. Int J Cardiol Heart Vasc. 2016; 222 41-46.
– reference: 34) Masashi Mukoyama， Kazuwa Nakao， Kiminori Hosoda， et al.: Brain natriuretic peptide as a novel cardiac hormone in humans. Evidence for an exquisite dual natriuretic peptide system， atrial natriuretic peptide and brain natriuretic peptide. J Clin Invest. 1991; 87(4) 1402-1412.
– reference: 1) Gaetano Santulli， Michele Ciccarelli， Bruno Trimarco ， et al.: Physical activity ameliorates cardiovascular health in elderly subjects: the functional role of the beta adrenergic system. Front Physiol 2013; 4 209.
– reference: 33) Dustin Harmon， Jennifer Rathousky， Faiza Choudhry， et al.: Readmission Risk Factors and Heart Failure With Preserved Ejection Fraction. J Am Osteopath Assoc. 2020; 120(12) 831-838.
– reference: 23) Rita Pavasini， Jack Guralnik， Justin C. Brown， et al.: Short Physical Performance Battery and all-cause mortality: systematic review and meta-analysis. BMC Med. 2016; 14(1) 215.
– reference: 7) Douglas S Lee， Philimon Gona， Ramachandran S Vassan， et al.: Relation of disease pathogenesis and risk factors to heart failure with preserved or reduced ejection fraction: insights from the framingham heart study of the national heart， lung， and blood institute. Circulation. 2009; 119(24) 3070-3077.
– reference: 36) Hirofumi Yasue， Michihiro Yoshimura， Hitoshi Sumida，et al.: Localization and mechanism of secretion of B-type natriuretic peptide in comparison with those of A-type natriuretic peptide in normal subjects and patients with heart failure. Circulation. 1994; 90(1) 195-203.
– reference: 32) Kayo Takahashi， Makoto Saito， Shinji Inaba， et al.: Contribution of the long-term care insurance certificate for predicting 1-year all-cause readmission compared with validated risk scores in elderly patients with heart failure. Open Heart. 2016; 3(2) e000501.
– reference: 21) Cecilie Fromholt Olsen， Astrid Bergland: "Reliability of the Norwegian version of the short physical performance battery in older people with and without dementia". BMC Geriatr. 2017; 17(1) 124.
– reference: 2) Cabinet Office Japan. Annual Report on the Aging Society: 2020 -Section 1 Situation on Aging. https://www8.cao.go.jp/kourei/english/a nnualreport/2020/pdf/2020.pdf (2021年12月6日引用).
– reference: 4) Hidenori Yaku， Neiko Ozasa， Takeshi Morimoto et al.: KCHF Study Investigators. Demographics， Management，and In-Hospital Outcome of Hospitalized Acute Heart Failure Syndrome Patients in Contemporary Real Clinical Practice in Japan - Observations From the Prospective， Multicenter Kyoto Congestive Heart Failure (KCHF) Registry. Circ J 2018; 82(11) 2811-2819.
– reference: 46) 若林秀隆：高齢者の廃用症候群の機能予後とリハビリテーション栄養管理．静脈経腸栄養．2013; 28: 1045-1050．
– reference: 15) 2021 年改訂版 心血管疾患におけるリハビリテーションに関するガイドライン https://www.j-circ.or.jp/cms/wp-content/uploads/2021/03/JCS2021_Makita.pdf（2021年12月20日引用）
– reference: 37) Alan S. Maisel， Kazuwa Nakao， Pintr Ponikowski， et al.: Japanese-Western consensus meeting on biomarkers. Int Heart J. 2011; 52(5) 253-265.
– reference: 28) Kenji Kanenawa， Akihiro Isotani， Kyohei Yamaji， et al.: The impact of frailty according to Clinical Frailty Scale on clinical outcome in patients with heart failure. ESC Heart Fail. 2021; 8(2) 1552-1561.
– reference: 10) Koichi Okita， Kazuya Yonezawa， Hirotaka Nishijima， et al.: Skeletal muscle metabolism limits exercise capacity in patients with chronic heart failure. Circulation. 1998; 98(18) 1886-1891.
– reference: 31) Marco Giuseppe Del Buono， Ross Arena， Barry A. Borlaug， et al.: Exercise Intolerance in Patients With Heart Failure: JACC State-of-the-Art Review. J Am Coll Cardiol. 2019; 73(17) 2209-2225.
– reference: 6) Taslima Bhuiyan， Mathew S. Maurer. Heart failure with preserved ejection fraction: persistent diagnosis， therapeutic enigma. Curr Cardiovasc Risk Rep. 2011; 5(5) 440-449.
– reference: 30) Kensuke Takabayashi， Shouji Kitaguchi， Kotaro Iwatsu， et al.: A decline in activities of daily living due to acute heart failure is an independent risk factor of hospitalization for heart failure and mortality. J Cardiol. 2019; 73(6) 522-529.
– reference: 35) Michihiro Yoshimura， Hirofumi Yasue， Ken Okumura， et al.: Different secretion patterns of atrial natriuretic peptide and brain natriuretic peptide in patients with congestive heart failure. Circulation. 1993; 87(2) 464-469.
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Snippet 【目的】左室駆出率が保持された心不全（heart failure with preserved ejection...
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SubjectTerms Geriatric Nutritional Risk Index
hear failure with preserved ejection fraction
Short physical Performance Battery
身体機能
高齢心不全
Title 左室駆出率が保持された高齢心不全患者におけるShort Physical Performance Batteryで分類した身体機能に関連する要因の検討
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