Evaluation of the Effect of Heart Failure Reversal Therapy on Exercise Capacity in Patients with Chronic Heart Failure and the Association with Co-morbidities

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Aims: New treatment modalities are needed to improve the aerobic capacity of patients with chronic heart failure (CHF), considering the increasing disease prevalence. This study was done to evaluate the effect of heart failure reversal therapy (HFRT) on exercise indices, viz.VO2 max and metabolic equivalents (METs).

Methodology: This retrospective study screened data of 147 patients who visited Madhavbaug Clinics between July 2018 and December 2018. The mean VO2 max and METs on day 30 of HFRT initiation was compared with baseline. Regression analysis was used to calculate the odds for increase in VO2 max and METs by HFRT,in specific co-morbidity.

Results: Of the 64 patients who fit the study criteria, the majority were men (n=51) with a mean age of 57.89 + 8.14 years. The most common comorbidity was hypertension (n=45), followed by diabetes (n=36) and coronary artery disease (n=27). Mean VO2 max and METs increased significantly at day 30 of HFRT initiation compared to the mean values on day 1 (p<0.05). Odds for elevation in VO2 max and METs were maximum in patients with MI (VO2 max: OR 4.95; CI [0.26–91.5]; METs: OR 3.46; CI [0.18–65.54]), ischaemic heart disease (VO2 max: OR 2.85; CI [0.32–24.7]; METs: OR 1.67; CI [0.18–15.29]) or obesity (VO2 max: OR 2.57; CI [0.29–22.4]; METs: OR 1.5; CI [0.16–13.78]). All odds were statistically insignificant (p>0.05).

Conclusion: HFRT leads to significant increase in the VO2 max and METs in CHF patients, indicating improved aerobic capacity.