• Camilla Cirelli, Raul Limonta, Greta Carioli, Emilia D'Elia, Pietro Ameri, Riccardo Maria Inciardi, Arianna Ghirardi, Luca Fazzini, Ferdinando Perra, Ginevra Rizzola, Erika Chiesa, Laura Tomasoni, Roberta Montisci, Antonello Gavazzi, Michele Senni, and Mauro Gori.
• Department of Medicine and Surgery, University of Milano Bicocca, Piazza dell'Ateneo Nuovo 1, 20126, Milan, Italy.
• Eur. J. Intern. Med. 2024 Aug 7.

BackgroundWorsening Heart Failure (WHF) is associated with adverse prognosis. Identifying novel prognostic markers in WHF is crucial. Gait speed (GS), a validated frailty index, is an easily obtainable parameter that may aid in reclassifying the risk of HF patients. We assessed the independent prognostic role of GS in WHF patients.MethodsWe studied 171 patients with chronic HF with worsening congestion symptoms and inadequate response to standard therapies, requiring intravenous diuretic treatment. The primary outcome was a composite of all-cause mortality or HF hospitalization. We assessed the association and the incremental value of GS, as compared to other clinical confounders, with the primary outcome.ResultsThe mean age was 76±11 years, 66 % were male, median BNP was 481 pg/ml, and median ejection fraction was 40 %. Over a median follow-up of 11.3 months, 71 events occurred. Lower GS was significantly associated with a higher risk of events (HR of 4.03, 95 % CI 2.25-7.21), along with neutrophil to lymphocyte ratio, BNP, QRS duration, natremia, and previous myocardial infarction. When added to the MAGGIC risk score and the other significant confounders identified, GS significantly enhanced the model risk prediction (Harrell's C-index 0.75 vs 0.71, p < 0.001). At Classification And Regression Tree analysis, GS≤0.8 m/s was the first parameter to be considered to risk stratify the population.ConclusionsGS, an easily obtainable marker of frailty, may contribute to improve the risk stratification of patients with WHF.Copyright © 2024. Published by Elsevier B.V.

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