{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T15:04:22Z","timestamp":1791644662502,"version":"4.3.4"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2021,7,16]],"date-time":"2021-07-16T00:00:00Z","timestamp":1626393600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Novartis Pharma Research Grants and Japan Heart Foundation Research Grant"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,8,19]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Functional decline due to skeletal muscle abnormalities leads to poor outcomes in patients with acute heart failure (AHF). The 6-minute walking test (6MWT) reliably evaluates functional capacity, but its technical difficulty for the elderly often limits its benefits. Although the Short Physical Performance Battery (SPPB) is a comprehensive measure of physical performance, its role in AHF remains unclear. This study aimed to examine the prognostic significance of SPPB compared to the 6MWT in elderly patients hospitalized for AHF.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>We retrospectively analysed 1192 elderly patients with AHF whose SPPB and 6MWT were measured during the hospitalization. The primary outcome measure was defined as a composite of all-cause death and heart failure readmission until 1 year after discharge. Patients with lower SPPB scores (0\u20136, n = 373) had significantly poorer outcomes than those with higher SPPB scores (7\u201312, n = 819) even after multivariable adjustment [adjusted hazard ratio (HR) 1.28, 95% confidence interval (CI) 1.01\u20131.61; P = 0.049], similar to those with shorter 6MWT (&amp;lt;median) than those with longer 6MWT (adjusted HR 1.61, 95% CI 1.27\u20132.04; P &amp;lt; 0.001). Although both SPPB and 6MWT [net reclassification index (NRI) 0.139, P = 0.036 and NRI 0.350, P &amp;lt; 0.001, respectively] exhibited incremental prognostic value over conventional risk factors of HF, the additive prognostic effect of 6MWT was superior to that of SPPB (NRI 0.300, P &amp;lt; 0.001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Reduced functional capacity assessed by either the SPPB or 6MWT was associated with worse outcomes in hospitalized elderly patients with AHF. The incremental prognostic value over the conventional risk factors was higher in 6MWT than in SPPB.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Trial Registration<\/jats:title>\n                  <jats:p>UMIN000023929<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjopen\/oeab006","type":"journal-article","created":{"date-parts":[[2021,7,16]],"date-time":"2021-07-16T18:10:34Z","timestamp":1626459034000},"source":"Crossref","is-referenced-by-count":42,"title":["Short physical performance battery vs. 6-minute walking test in hospitalized elderly patients with heart failure"],"prefix":"10.1093","volume":"1","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2416-5865","authenticated-orcid":false,"given":"Takeshi","family":"Kitai","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital , Kobe, Japan"},{"name":"Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center , 6-1 Kishibe Shin-machi, Osaka 564-8565, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takayuki","family":"Shimogai","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Kobe City Medical Center General Hospital , Kobe, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W H Wilson","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Kaufman Center for Heart Failure, Heart and Vascular Institute, Cleveland Clinic , Cleveland, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kentaro","family":"Iwata","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Kobe City Medical Center General Hospital , Kobe, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Xanthopoulos","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University General Hospital of Larissa , Larissa, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuto","family":"Otsuka","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Kobe City Medical Center General Hospital , Kobe, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fumika","family":"Nakada","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Kobe City Medical Center General Hospital , Kobe, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rina","family":"Yokoyama","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Kobe City Medical Center General Hospital , Kobe, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kentaro","family":"Kamiya","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, School of Allied Health Science, Kitasato University , Sagamihara, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Saito","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Kameda Medical Center , Kamogawa, Japan"},{"name":"Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine , Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuya","family":"Saito","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, The Sakakibara Heart Institute of Okayama , Okayama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emi","family":"Maekawa","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Kitasato University School of Medicine , Sagamihara, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaaki","family":"Konishi","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Yokohama City University Medical Center , Yokohama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuki","family":"Ogasahara","sequence":"additional","affiliation":[{"name":"Department of Nursing, The Sakakibara Heart Institute of Okayama , Okayama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kentaro","family":"Jujo","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Nishiarai Heart Center Hospital , Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Wada","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University , Saitama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takatoshi","family":"Kasai","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine , Tokyo, Japan"},{"name":"Cardiovascular Respiratory Sleep Medicine, Juntendo Univeristy Graduate School of Medicine , Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinichi","family":"Momomura","sequence":"additional","affiliation":[{"name":"Saitama Citizens Medical Center , Saitama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chayakrit","family":"Krittanawong","sequence":"additional","affiliation":[{"name":"Section of Cardiology, Baylor School of Medicine , Houston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Skoularigis","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University General Hospital of Larissa , Larissa, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filippos","family":"Triposkiadis","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University General Hospital of Larissa , Larissa, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuyuki","family":"Kagiyama","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine , Tokyo, Japan"},{"name":"Department of Digital Health and Telemedicine R&D, Juntendo University , Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yutaka","family":"Furukawa","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital , Kobe, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuya","family":"Matsue","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine , Tokyo, Japan"},{"name":"Cardiovascular Respiratory Sleep Medicine, Juntendo Univeristy Graduate School of Medicine , Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,7,16]]},"reference":[{"key":"2024011620383186000_oeab006-B1","doi-asserted-by":"crossref","first-page":"e139","DOI":"10.1161\/CIR.0000000000000757","article-title":"American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee. Heart Disease and Stroke Statistics-2020 Update: a report from the American Heart Association","volume":"141","author":"Virani","year":"2020","journal-title":"Circulation"},{"key":"2024011620383186000_oeab006-B2","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1038\/nrcardio.2017.70","article-title":"Physical function and exercise training in older patients with heart failure","volume":"14","author":"Coats","year":"2017","journal-title":"Nat Rev Cardiol"},{"key":"2024011620383186000_oeab006-B3","doi-asserted-by":"crossref","first-page":"M9","DOI":"10.1093\/eurheartj\/suz216","article-title":"Monitoring functional capacity in heart failure","volume":"21","author":"Piepoli","year":"2019","journal-title":"Eur Heart J Suppl"},{"key":"2024011620383186000_oeab006-B4","doi-asserted-by":"crossref","first-page":"873","DOI":"10.1161\/CIR.0b013e31829b5b44","article-title":"Exercise standards for testing and training: a scientific statement from the American Heart Association","volume":"128","author":"Fletcher","year":"2013","journal-title":"Circulation"},{"key":"2024011620383186000_oeab006-B5","doi-asserted-by":"crossref","first-page":"1702","DOI":"10.1001\/jama.1993.03510140062030","article-title":"Prediction of mortality and morbidity with a 6-minute walk test in patients with left ventricular dysfunction. SOLVD Investigators","volume":"270","author":"Bittner","year":"1993","journal-title":"JAMA"},{"key":"2024011620383186000_oeab006-B6","doi-asserted-by":"crossref","first-page":"e894","DOI":"10.1161\/CIR.0000000000000483","article-title":"Prioritizing functional capacity as a principal end point for therapies oriented to older adults with cardiovascular disease: a scientific statement for healthcare professionals from the American Heart Association","volume":"135","author":"Forman","year":"2017","journal-title":"Circulation"},{"key":"2024011620383186000_oeab006-B7","doi-asserted-by":"crossref","first-page":"M85","DOI":"10.1093\/geronj\/49.2.M85","article-title":"A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission","volume":"49","author":"Guralnik","year":"1994","journal-title":"J Gerontol"},{"key":"2024011620383186000_oeab006-B8","author":"Reflection paper on physical frailty: instruments for baseline characterisation of older populations in clinical trials"},{"key":"2024011620383186000_oeab006-B9","doi-asserted-by":"crossref","first-page":"2191","DOI":"10.1253\/circj.CJ-17-0816","article-title":"Impact of frailty markers for unplanned hospital readmission following transcatheter aortic valve implantation","volume":"82","author":"Saji","year":"2018","journal-title":"Circ J"},{"key":"2024011620383186000_oeab006-B10","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1016\/j.atherosclerosis.2016.11.023","article-title":"Ankle-brachial index and physical function in older individuals: the Atherosclerosis Risk in Communities (ARIC) study","volume":"257","author":"Matsushita","year":"2017","journal-title":"Atherosclerosis"},{"key":"2024011620383186000_oeab006-B11","doi-asserted-by":"crossref","first-page":"2112","DOI":"10.1002\/ejhf.1926","article-title":"Prevalence and prognostic impact of the coexistence of multiple frailty domains in elderly patients with heart failure: The FRAGILE-HF cohort study","volume":"22","author":"Matsue","year":"2020","journal-title":"Eur J Heart Fail"},{"key":"2024011620383186000_oeab006-B12","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1161\/01.CIR.88.1.107","article-title":"Survival after the onset of congestive heart failure in Framingham Heart Study subjects","volume":"88","author":"Ho","year":"1993","journal-title":"Circulation"},{"key":"2024011620383186000_oeab006-B13","doi-asserted-by":"crossref","first-page":"714","DOI":"10.1007\/s12603-012-0391-7","article-title":"The integration of frailty into clinical practice: preliminary results from the Gerontopole","volume":"16","author":"Subra","year":"2012","journal-title":"J Nutr Health Aging"},{"key":"2024011620383186000_oeab006-B14","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1093\/gerona\/glq167","article-title":"Predictive value of the Short Physical Performance Battery following hospitalization in older patients","volume":"66A","author":"Volpato","year":"2011","journal-title":"J Gerontol A Biol Sci Med Sci"},{"key":"2024011620383186000_oeab006-B15","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1164\/ajrccm.166.1.at1102","article-title":"ATS statement: guidelines for the six-minute walk test","volume":"166","author":"ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories","year":"2002","journal-title":"Am J Respir Crit Care Med"},{"key":"2024011620383186000_oeab006-B16","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1016\/j.jacc.2014.12.018","article-title":"2014 ACC\/AHA key data elements and definitions for cardiovascular endpoint events in clinical trials: a report of the American College of Cardiology\/American Heart Association task force on clinical data standards (writing committee to develop cardiovascular endpoints data standards)","volume":"66","author":"Hicks","year":"2015","journal-title":"J Am Coll Cardiol"},{"key":"2024011620383186000_oeab006-B17","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1016\/j.jacc.2014.12.018","article-title":"2014 ACC\/AHA key data elements and definitions for cardiovascular endpoint events in clinical trials: a report of the American College of Cardiology\/American Heart Association task force on clinical data standards (writing committee to develop cardiovascular endpoints data standards)","volume":"66","author":"Hicks","year":"2015","journal-title":"J Am Coll Cardiol"},{"key":"2024011620383186000_oeab006-B35","doi-asserted-by":"crossref","first-page":"2387","DOI":"10.1001\/jama.2014.5616","article-title":"Effect of structured physical activity on prevention of major mobility disability in older adults: the LIFE study randomized clinical trial","volume":"311","author":"Pahor","year":"2014","journal-title":"Jama"},{"key":"2024011620383186000_oeab006-B18","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1001\/jama.2010.1923","article-title":"Gait speed and survival in older adults","volume":"305","author":"Studenski","year":"2011","journal-title":"JAMA"},{"key":"2024011620383186000_oeab006-B19","doi-asserted-by":"crossref","first-page":"c4467","DOI":"10.1136\/bmj.c4467","article-title":"Objectively measured physical capability levels and mortality: systematic review and meta-analysis","volume":"341","author":"Cooper","year":"2010","journal-title":"BMJ"},{"key":"2024011620383186000_oeab006-B20","doi-asserted-by":"crossref","first-page":"M146","DOI":"10.1093\/gerona\/56.3.M146","article-title":"Frailty in older adults: evidence for a phenotype","volume":"56","author":"Fried","year":"2001","journal-title":"J Gerontol A Biol Sci Med Sci"},{"key":"2024011620383186000_oeab006-B21","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1016\/j.jamda.2013.03.022","article-title":"Frailty consensus: a call to action","volume":"14","author":"Morley","year":"2013","journal-title":"J Am Med Direc Assoc"},{"key":"2024011620383186000_oeab006-B22","doi-asserted-by":"crossref","first-page":"752","DOI":"10.1016\/S0140-6736(12)62167-9","article-title":"Frailty in elderly people","volume":"381","author":"Clegg","year":"2013","journal-title":"Lancet"},{"key":"2024011620383186000_oeab006-B23","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1111\/j.1532-5415.2010.02764.x","article-title":"Prevalence and 10-year outcomes of frailty in older adults in relation to deficit accumulation","volume":"58","author":"Song","year":"2010","journal-title":"J Am Geriatr Soc"},{"key":"2024011620383186000_oeab006-B24","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1503\/cmaj.050051","article-title":"A global clinical measure of fitness and frailty in elderly people","volume":"173","author":"Rockwood","year":"2005","journal-title":"Can Med Assoc J"},{"key":"2024011620383186000_oeab006-B25","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1056\/NEJM199503023320902","article-title":"Lower-extremity function in persons over the age of 70 years as a predictor of subsequent disability","volume":"332","author":"Guralnik","year":"1995","journal-title":"N Engl J Med"},{"key":"2024011620383186000_oeab006-B26","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1111\/j.1447-0594.2012.00920.x","article-title":"Using the Short Physical Performance Battery to screen for frailty in young-old adults with distinct socioeconomic conditions","volume":"13","author":"da Camara","year":"2013","journal-title":"Geriatr Gerontol Int"},{"key":"2024011620383186000_oeab006-B27","doi-asserted-by":"crossref","first-page":"916","DOI":"10.1016\/S0895-4356(02)00436-5","article-title":"Reliability and sensitivity to change assessed for a summary measure of lower body function: results from the Women\u2019s Health and Aging Study","volume":"55","author":"Ostir","year":"2002","journal-title":"J Clin Epidemiol"},{"key":"2024011620383186000_oeab006-B28","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1016\/j.cardfail.2010.01.004","article-title":"Lower extremity performance measures predict long-term prognosis in older patients hospitalized for heart failure","volume":"16","author":"Chiarantini","year":"2010","journal-title":"J Card Fail"},{"key":"2024011620383186000_oeab006-B29","doi-asserted-by":"crossref","first-page":"887","DOI":"10.1016\/j.ahj.2013.07.032","article-title":"Frailty and risk for heart failure in older adults: the health, aging, and body composition study","volume":"166","author":"Khan","year":"2013","journal-title":"Am Heart J"},{"key":"2024011620383186000_oeab006-B30","doi-asserted-by":"crossref","first-page":"e005254","DOI":"10.1161\/CIRCHEARTFAILURE.118.005254","article-title":"Physical function, frailty, cognition, depression, and quality of life in hospitalized adults &gt;\/=60 years with acute decompensated heart failure with preserved versus reduced ejection fraction","volume":"11","author":"Warraich","year":"2018","journal-title":"Circ Heart Fail"},{"key":"2024011620383186000_oeab006-B31","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1080\/0361073X.2013.839021","article-title":"Physical performance and short-term mortality in very old Mexican Americans","volume":"39","author":"Panas","year":"2013","journal-title":"Exp Aging Res"},{"key":"2024011620383186000_oeab006-B32","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1186\/s12916-016-0763-7","article-title":"Short Physical Performance Battery and all-cause mortality: systematic review and meta-analysis","volume":"14","author":"Pavasini","year":"2016","journal-title":"BMC Med"},{"key":"2024011620383186000_oeab006-B33","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1186\/s12872-020-01725-5","article-title":"Physical functional performance and prognosis in patient with heart failure: a systemic review and meta-analysis","volume":"20","author":"Fuentes-Abolafio","year":"2020","journal-title":"BMC Cardiovasc Disorders"},{"key":"2024011620383186000_oeab006-B34","doi-asserted-by":"publisher","DOI":"10.1093\/eurjpc\/zwab044","article-title":"Functional capacity assessment and minimal clinically important difference in post-acute cardiac patients: the role of Short Physical Performance Battery","author":"Rinaldo","year":"2021","journal-title":"Eur J Prev Cardiol"}],"container-title":["European Heart Journal Open"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ehjopen\/advance-article-pdf\/doi\/10.1093\/ehjopen\/oeab006\/39070743\/oeab006.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjopen\/article-pdf\/1\/1\/oeab006\/56151210\/oeab006.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjopen\/article-pdf\/1\/1\/oeab006\/56151210\/oeab006.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,16]],"date-time":"2024-01-16T20:39:00Z","timestamp":1705437540000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjopen\/article\/doi\/10.1093\/ehjopen\/oeab006\/6322955"}},"subtitle":[],"editor":[{"given":"Magnus","family":"B\u00e4ck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2021,7,16]]},"references-count":35,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,8,19]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjopen\/oeab006","relation":{},"ISSN":["2752-4191"],"issn-type":[{"value":"2752-4191","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,8,1]]},"published":{"date-parts":[[2021,7,16]]},"article-number":"oeab006"}}