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Impact of cerebral oxygen saturation on mortality and rehospitalisation in patients with heart failure and the role of physical activity as a modifying factor : the HARVEST-Malmö Study

Zaghi, Amir LU orcid ; Jujic, Amra LU orcid ; Zilic, Haris LU ; Dieden, Anna LU orcid ; Bachus, Erasmus LU ; Holm, Hannes LU and Magnusson, Martin LU orcid (2025) In Heart
Abstract

BACKGROUND: The cross-sectional association between cerebral tissue oxygen saturation (SctO
2) and heart failure (HF) has been previously studied, but the prognostic significance of SctO
2 in HF remains uncertain. This study aimed to assess the role of SctO
2 as a risk factor for all-cause mortality and rehospitalisation, as well as to explore the cross-sectional association between physical activity and SctO
2 in a Swedish HF cohort.

METHODS: In 102 patients with HF (mean age 70.2 years (±12.4); 21.6% women), near-infrared spectroscopy was used to assess SctO
2. Adjusted Cox regression analyses were conducted to examine the associations between resting SctO
2 levels and all-cause mortality and... (More)

BACKGROUND: The cross-sectional association between cerebral tissue oxygen saturation (SctO
2) and heart failure (HF) has been previously studied, but the prognostic significance of SctO
2 in HF remains uncertain. This study aimed to assess the role of SctO
2 as a risk factor for all-cause mortality and rehospitalisation, as well as to explore the cross-sectional association between physical activity and SctO
2 in a Swedish HF cohort.

METHODS: In 102 patients with HF (mean age 70.2 years (±12.4); 21.6% women), near-infrared spectroscopy was used to assess SctO
2. Adjusted Cox regression analyses were conducted to examine the associations between resting SctO
2 levels and all-cause mortality and the initial occurrence of postdischarge rehospitalisations. The associations between self-reported physical inactivity and SctO
2 were explored by using multivariable linear and logistic regression analyses.

RESULTS: The median follow-up time to death of any cause and first-of-any rehospitalisation was 830 (IQR: 519-1283) and 208 (72-584) days, respectively. During follow-up, 31 (30.4%) patients died and 63 (61.8%) were rehospitalised. Higher SctO
2 was associated with lower risk of mortality (HR 0.86; 95% CI 0.77 to 0.95; p=0.002) but not with rehospitalisation risk (HR 0.96; 95% CI 0.90 to 1.02; p=0.162). Physical inactivity (≤1 hour per week of strenuous activity) was associated with lower SctO
2 (β-1.56; 95% CI -3.07 to -0.05, p=0.043).

CONCLUSION: Higher SctO2 at rest is associated with lower risk of all-cause mortality but it was not possible to show significant association with first-of-any rehospitalisation risk in patients with HF. Physical inactivity is associated with lower cerebral oxygen saturation at rest. These findings could suggest SctO2 as a potential marker associated with long-term outcomes in HF, warranting larger confirmatory studies.

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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
epub
subject
in
Heart
publisher
BMJ Publishing Group
external identifiers
  • pmid:41365671
ISSN
1355-6037
DOI
10.1136/heartjnl-2025-326503
language
English
LU publication?
yes
additional info
© Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY. Published by BMJ Group.
id
2afe483a-91e5-496d-a27b-dd0d44976a65
date added to LUP
2025-12-15 10:25:43
date last changed
2025-12-15 16:01:18
@article{2afe483a-91e5-496d-a27b-dd0d44976a65,
  abstract     = {{<p>BACKGROUND: The cross-sectional association between cerebral tissue oxygen saturation (SctO<br>
 2) and heart failure (HF) has been previously studied, but the prognostic significance of SctO<br>
 2 in HF remains uncertain. This study aimed to assess the role of SctO<br>
 2 as a risk factor for all-cause mortality and rehospitalisation, as well as to explore the cross-sectional association between physical activity and SctO<br>
 2 in a Swedish HF cohort.<br>
 </p><p>METHODS: In 102 patients with HF (mean age 70.2 years (±12.4); 21.6% women), near-infrared spectroscopy was used to assess SctO<br>
 2. Adjusted Cox regression analyses were conducted to examine the associations between resting SctO<br>
 2 levels and all-cause mortality and the initial occurrence of postdischarge rehospitalisations. The associations between self-reported physical inactivity and SctO<br>
 2 were explored by using multivariable linear and logistic regression analyses.<br>
 </p><p>RESULTS: The median follow-up time to death of any cause and first-of-any rehospitalisation was 830 (IQR: 519-1283) and 208 (72-584) days, respectively. During follow-up, 31 (30.4%) patients died and 63 (61.8%) were rehospitalised. Higher SctO<br>
 2 was associated with lower risk of mortality (HR 0.86; 95% CI 0.77 to 0.95; p=0.002) but not with rehospitalisation risk (HR 0.96; 95% CI 0.90 to 1.02; p=0.162). Physical inactivity (≤1 hour per week of strenuous activity) was associated with lower SctO<br>
 2 (β-1.56; 95% CI -3.07 to -0.05, p=0.043).<br>
 </p><p>CONCLUSION: Higher SctO2 at rest is associated with lower risk of all-cause mortality but it was not possible to show significant association with first-of-any rehospitalisation risk in patients with HF. Physical inactivity is associated with lower cerebral oxygen saturation at rest. These findings could suggest SctO2 as a potential marker associated with long-term outcomes in HF, warranting larger confirmatory studies.</p>}},
  author       = {{Zaghi, Amir and Jujic, Amra and Zilic, Haris and Dieden, Anna and Bachus, Erasmus and Holm, Hannes and Magnusson, Martin}},
  issn         = {{1355-6037}},
  language     = {{eng}},
  month        = {{12}},
  publisher    = {{BMJ Publishing Group}},
  series       = {{Heart}},
  title        = {{Impact of cerebral oxygen saturation on mortality and rehospitalisation in patients with heart failure and the role of physical activity as a modifying factor : the HARVEST-Malmö Study}},
  url          = {{http://dx.doi.org/10.1136/heartjnl-2025-326503}},
  doi          = {{10.1136/heartjnl-2025-326503}},
  year         = {{2025}},
}