Effect of family-based weight management on cardiac function and readmission in elderly patients with heart failure / 中华全科医师杂志

ABSTRACT

Objective:To explore the effect of family-based body weight management on cardiac function and readmission in patients with chronic heart failure.Methods:The study was a single-blind randomized controlled trial. Elderly patients with heart failure who were treated in Yichuan Community Health Service Center of Putuo District from June 2019 to May 2020 were enrolled in the study. The patients were randomly divided into the control group and the intervention group. All patients were treated with anti-heart failure drugs; in addition, the intervention group received family-based weight management and the control group received the conventional weight management. The cognition of self-management and weight management of patients was assessed by the Heart Failure Patient Self-Management Scale and the Weight Management Scale, before intervention and after 12 months of intervention, respectively. At the same time, the 6-min walking test, the New York Heart Association (NYHA) cardiac function grading assessment were performed, plasma N-terminal proB-type natriuretic peptide (NT-proBNP) was measured, left ventricular ejection fraction (LVEF) was determined and body weight measurement was completed; and the readmissions of patients due to heart failure during follow-up were recorded.Results:A total of 249 patients aged (65.2±2.9) years, including 104 males (41.8%) were enrolled; there were 124 in the intervention group and 125 in the control group. There were no significant differences in age, gender, marital status and educational level between the two groups (all P>0.05). There were no significant differences in the baseline scores of the Heart Failure Patient Self-Management Scale between the two groups (all P>0.05). After intervention, all scores of the intervention group were significantly better than those of the control group (all P<0.01). There were no significant differences in the scores of the Weight Management Scale between the two groups before intervention (all P>0.05), whereas all scores of the intervention group were significantly better than those of the control group after intervention (all P<0.01). There was no significant difference in body weight between the two groups before intervention ( P=0.397), while the average body weight of the intervention group was significantly lower than that of the control group after intervention ( P=0.029). At baseline, there were no significant differences in the LVEF, NT-proBNP level, 6-min walking distance, and the proportion of NYHA patients with grade Ⅲ/Ⅳ heart function between the two groups (all P>0.05). After intervention, LVEF and 6-min walking distance of patients in the intervention group were significantly higher than those in the control group (all P<0.01); the plasma NT-proBNP level and the proportion of NYHA grade Ⅲ/Ⅳ were significantly lower than those in the control group (all P<0.01). During follow-up, the rate of readmission due to heart failure in the intervention group was lower than that in the control group ( P<0.001). Conclusion:Family-based weight management can improve heart function and reduce the readmission rate in elderly patients with heart failure.