Evidence map›Paper›PMID 34246602›Full record

Trial reportJACC. Heart failure2021

Rehabilitation Intervention in Older Patients With Acute Heart Failure With Preserved Versus Reduced Ejection Fraction.

Robert J Mentz, David J Whellan, Gordon R Reeves, Amy M Pastva, Pamela Duncan, Bharathi Upadhya, M Benjamin Nelson, Haiying Chen, Shelby D Reed, Paul B Rosenberg and 3 more

Registry-linked trialOpen access · greenAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in JACC. Heart failure, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02196038 (REHAB-HF), which is not on this map. Cited by 44 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
44citing papers in PubMed, 3 pooled it
8.5field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02196038 nacompletednot on this map

REHAB-HF: A Trial of Rehabilitation Therapy in Older Acute Heart Failure Patients

TypeinterventionalSponsorWake Forest University Health SciencesRan2014 to 2020Enrolled349ConditionsAcute Decompensated Heart FailureArmsmulti-domain rehabilitation intervention, Attention Control
3 · Its place in the literature

Who cites it

44 citing papers in PubMed, 3 syntheses or guidelines pooled it, 81 citations in OpenAlex.

  1. Pooled it
  2. Exercise-based cardiac rehabilitation for adults with heart failure.The Cochrane database of systematic reviews · 2024
    Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 4 institutions in 1 country.

Robert J MentzDivision of Cardiology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA.
David J WhellanDepartment of Medicine, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Gordon R ReevesDoctor of Physical Therapy Division, Departments of Orthopaedic Surgery, Medicine, & Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA.
Amy M PastvaDoctor of Physical Therapy Division, Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, North Carolina, USA.
Pamela DuncanDepartment of Neurology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
Bharathi UpadhyaSection on Cardiovascular Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
M Benjamin NelsonSection on Cardiovascular Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
Haiying ChenDepartment of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
Shelby D ReedDepartment of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina.
Paul B RosenbergDivision of Cardiology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA.
Alain G BertoniDepartment of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
Christopher M O'ConnorInova Heart and Vascular Institute, Falls Church, Virginia, USA.
Dalane W KitzmanSection on Cardiovascular Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA; Sections on Geriatrics, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA. Electronic address: dkitzman@wakehealth.edu.
Wake Forest University · USDuke University · USAlaska Heart and Vascular Institute · USThomas Jefferson University · US

Funding

Wake Forest Claude D. Pepper OAIC - RenewalP30AG021332 · NIA · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI Denise Kathryn Houston · 2002 to 2026
$36.4M
Resource Core 3 - Metabolomics CoreP30AG028716 · NIA · DUKE UNIVERSITY · PI Sarah B. Peskoe · 2006 to 2026
$24.6M
REHAB-HF: A Trial of Rehabilitation Therapy in Older Acute Heart Failure PatientsR01AG045551 · NIA · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI KITZMAN, DALANE W · 2014 to 2018
$6.8M
Pepper OAIC Coordinating CenterU24AG059624 · NIA · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI DALANE W KITZMAN · 2018 to 2026
$6.0M
Exercise Intolerance in Older HFPEF PatientsR01AG018915 · NIA · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI KITZMAN, DALANE W · 2001 to 2019
$5.2M
NIA NIH HHS P30 AG021332NIA NIH HHS P30 AG028716NIA NIH HHS R01 AG018915NIA NIH HHS R01 AG045551NIA NIH HHS U24 AG059624
6 · The paper itself

Abstract

objectivesThis study assessed for treatment interactions by ejection fraction (EF) subgroup (≥45% [heart failure with preserved ejection fraction (HFpEF); vs <45% [heart failure with reduced ejection fraction (HFrEF)]).

backgroundThe REHAB-HF trial showed that an early multidomain rehabilitation intervention improved physical function, frailty, quality-of-life, and depression in older patients hospitalized with acute decompensated heart failure (ADHF).

methodsThree-month outcomes were: Short Physical Performance Battery (SPPB), 6-min walk distance (6MWD), and Kansas City Cardiomyopathy Questionnaire (KCCQ). Six-month end points included all-cause rehospitalization and death and a global rank of death, all-cause rehospitalization, and SPPB. Prespecified significance level for interaction was P ≤ 0.1.

resultsAmong 349 total participants, 185 (53%) had HFpEF and 164 (47%) had HFrEF. Compared with HFrEF, HFpEF participants were more often women (61% vs 43%) and had significantly worse baseline physical function, frailty, quality of life, and depression. Although interaction P values for 3-month outcomes were not significant, effect sizes were larger for HFpEF vs HFrEF: SPPB +1.9 (95% CI: 1.1-2.6) vs +1.1 (95% CI: 0.3-1.9); 6MWD +40 meters (95% CI: 9 meters-72 meters) vs +27 (95% CI: -6 meters to 59 meters); KCCQ +9 (2-16) vs +6 (-2 to 14). All-cause rehospitalization rate was nominally lower with intervention in HFpEF but not HFrEF [effect size 0.83 (95% CI: 0.64-1.09) vs 0.99 (95% CI: 0.74-1.33); interaction P = 0.40]. There were significantly greater treatment benefits in HFpEF vs HFrEF for all-cause death [interaction P = 0.08; intervention rate ratio 0.63 (95% CI: 0.25-1.61) vs 2.21 (95% CI: 0.78-6.25)], and the global rank end point (interaction P = 0.098) with benefit seen in HFpEF [probability index 0.59 (95% CI: 0.50-0.68)] but not HFrEF.

conclusionsAmong older patients hospitalized with ADHF, compared with HFrEF those with HFpEF had significantly worse impairments at baseline and may derive greater benefit from the intervention. (A Trial of Rehabilitation Therapy in Older Acute Heart Failure Patients [REHAB-HF]; NCT02196038).

Indexed as

Heart FailureVentricular Dysfunction, LeftAgedFemaleHumansPrognosisQuality of LifeStroke Volumeagingheart failureHFpEFphysical functionrehabilitation

Identifiers

PMID34246602
PMCPMC8487922
OpenAlexW3182577532

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.