{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T04:28:59Z","timestamp":1777523339835,"version":"3.51.4"},"reference-count":19,"publisher":"BMJ","issue":"1","funder":[{"DOI":"10.13039\/501100000274","name":"British Heart Foundation","doi-asserted-by":"publisher","award":["040\/PSS\/17\/18\/NACR"],"award-info":[{"award-number":["040\/PSS\/17\/18\/NACR"]}],"id":[{"id":"10.13039\/501100000274","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000274","name":"British Heart Foundation","doi-asserted-by":"publisher","award":["040\/PSS\/17\/18\/NACR"],"award-info":[{"award-number":["040\/PSS\/17\/18\/NACR"]}],"id":[{"id":"10.13039\/501100000274","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Open Heart"],"accepted":{"date-parts":[[2018,12,9]]},"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Patients with heart failure (HF) attending cardiac rehabilitation (CR) benefit in terms of improved quality of life, physical fitness and reduced hospital admissions. Too few patients with HF attend CR and little data exist on the characteristics of those who do especially in respect of physical fitness. This study evaluates the extent by which clinical and demographic factors determine walking fitness in patients with a primary diagnosis of HF.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Clinical data from the British Heart Foundation National Audit of Cardiac Rehabilitation identified 1519 patients with HF who completed an incremental shuttle walk test (ISWT). Stepwise regression accounting for age, gender and multiple potential confounders assessed their contribution to total walking distance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Mean age was 64.5 (SD 12.70) years with a range of ISWT distances across gender and associated comorbidities from 215 to 282 m. Walking distance reduced by 4.9 m for each year increase in age above mean age (p&lt;0.001). After accounting for confounders, females walked 42.1 m less than males (p\u2264 0.001). Pulmonary disease and the existence of depression was associated with a 39.3\u2009and 52.2\u2009m reduction in walking distance, respectively. Body mass index &gt;30 was associated with 28.5\u2009m reduction in walking distance (p&lt;0.001). HF severity failed to improve the regression model fit or achieve significance in the analysis<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Age, gender and the presence of pulmonary disease or depression were highly significant factors in predicting walking fitness in patients with HF. The study also produced a set of reference values based on these four factors to aid the interpretation of walking fitness in patients with HF.<\/jats:p><\/jats:sec>","DOI":"10.1136\/openhrt-2018-000866","type":"journal-article","created":{"date-parts":[[2019,2,28]],"date-time":"2019-02-28T11:21:02Z","timestamp":1551352862000},"page":"e000866","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Determinants of walking fitness in patients with heart failure attending cardiac rehabilitation"],"prefix":"10.1136","volume":"6","author":[{"given":"Patrick","family":"Doherty","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander Stephen","family":"Harrison","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rashed","family":"Hossain","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,2,27]]},"reference":[{"key":"2024051419512276000_6.1.e000866.1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jacc.2015.10.044","article-title":"Exercise-Based Cardiac Rehabilitation for Coronary Heart Disease","volume":"67","author":"Anderson","year":"2016","journal-title":"J Am Coll Cardiol"},{"key":"2024051419512276000_6.1.e000866.2","doi-asserted-by":"crossref","DOI":"10.1136\/openhrt-2014-000163","article-title":"Exercise-based rehabilitation for heart failure: systematic review and meta-analysis","volume":"2","author":"Sagar","year":"2015","journal-title":"Open Heart"},{"key":"2024051419512276000_6.1.e000866.3","unstructured":"2018. National Audit of Cardiac Rehabilitation: annual statistical report 2017. Available from: https:\/\/www.bhf.org.uk\/publications\/statistics\/national-audit-of-cardiac-rehabilitation-annual-statistical-report-2017 [Accessed 27 Feb 2018]."},{"key":"2024051419512276000_6.1.e000866.4","unstructured":"NICE CG172 , 2013. Myocardial infarction: cardiac rehabilitation and prevention of further cardiovascular disease. Clinical guideline [CG172]. Available from: https:\/\/www.nice.org.uk\/guidance\/cg172 [Accessed 27 Feb 2018]."},{"key":"2024051419512276000_6.1.e000866.5","unstructured":"National Institute for Health and Care Excellence . Chronic heart failure in adults: diagnosis and management (NICE guideline NG106), 2018. Available: https:\/\/www.\u200bnice.\u200borg.\u200buk\/\u200bguidance\/\u200bng106 [Accessed 02 Jan 2019]."},{"key":"2024051419512276000_6.1.e000866.6","doi-asserted-by":"crossref","first-page":"664","DOI":"10.1177\/2047487312449597","article-title":"Secondary prevention in the clinical management of patients with cardiovascular diseases. Core components, standards and outcome measures for referral and delivery: a policy statement from the cardiac rehabilitation section of the European Association for Cardiovascular Prevention & Rehabilitation. 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National Heart Failure Audit 2017. Available from: http:\/\/www.ucl.ac.uk\/nicor\/audits\/heartfailure [Accessed 27 Feb 2018]."},{"key":"2024051419512276000_6.1.e000866.12","doi-asserted-by":"crossref","first-page":"h5000","DOI":"10.1136\/bmj.h5000","article-title":"Cardiac rehabilitation","volume":"351","author":"Dalal","year":"2015","journal-title":"BMJ"},{"key":"2024051419512276000_6.1.e000866.13","unstructured":"British Association for Cardiovascular Prevention and Rehabilitation (BACPR) , 2017. Standards and Core Components for Cardiovascular Disease Prevention and Rehabilitation. 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