The effectiveness and optimization of self-monitored cardiac rehabilitation in elderly heart failure patients with frailty.

2022 Fiscal Year Final Research Report

• Project/Area Number: 19K17578
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 53020:Cardiology-related
• Research Institution: Jichi Medical University
• Principal Investigator: Komori Takahiro 自治医科大学, 医学部, 講師 (80406107)
• Project Period (FY): 2019-04-01 – 2023-03-31
• Keywords: 心不全 / リハビリテーション / 認知機能 / フレイル

Outline of Final Research Achievements

COVID-19 pandemic greatly affected the progress of this research. We finally enrolled 27 patients, and only 5 patients were able to perform the study as planned. After self-monitored cardiac rehabilitation, left ventricular diastolic dimension decreased, left ventricular ejection fraction increased, peak VO2 increased, peak VO2/HR increased, VE/VCO2 slope decreased, MMSE and MoCA-J scores decreased. Cross-sectional analysis of the characteristics of 27 patients of low BDNF was performed. When divided into two groups by median BDNF, the low BDNF group was older, had a higher prevalence of cardiovascular disease, had higher extracellular water content (ECW/TBW) and body water content, MoCA-J and MMSE were lower in the low BDNF group than in the high BDNF group.
The present research suggested that self-monitored cardiac rehabilitation may be improve heart failure itself and frailty. It also suggested that BDNF may be associated with frailty and exercise capacity.

Free Research Field

医学

Academic Significance and Societal Importance of the Research Achievements

今回の研究では仮説を検証するための十分なデータが不足していたが、非監視型心臓リハビリテーションが心不全自体や、合併しているフレイルの状態を改善させるのに有効である可能性が示唆された。また、BDNFがそれらに関係している可能性も考えられた。通院心臓リハビリテーションに参加できない患者は依然として多いため、非監視型であっても心臓リハビリテーションを推奨する裏付けになると考えられる。また、マイオカインの一つであるBDNFが身体機能や認知機能に果たす役割が推察され、リハビリテーションがもたらす体液因子の影響解明に役立つものと考えられる。