Academic Journal
Προβολή σε EDS

Door-to-Cardiac Rehabilitation Time and Clinical Outcomes in Patients Hospitalized for Acute Heart Failure: A Nationwide Japanese Registry.

Λεπτομέρειες βιβλιογραφικής εγγραφής
Τίτλος: Door-to-Cardiac Rehabilitation Time and Clinical Outcomes in Patients Hospitalized for Acute Heart Failure: A Nationwide Japanese Registry.
Συγγραφείς: Katano S; Division of Rehabilitation Sapporo Medical University Hospital Sapporo Japan.; Department of Rehabilitation Sapporo Medical University School of Medicine Sapporo Japan., Yano T; Division of Cardiovascular-Kidney-Metabolic Medicine, Department of Internal Medicine Sapporo Medical University School of Medicine Sapporo Japan., Kono Y; Department of Rehabilitation Fujita Health University Hospital Toyoake Japan., Sawamura A; Department of Cardiology Ichinomiya Municipal Hospital Ichinomiya Japan., Kanaoka K; Department of Medical and Health Information Management National Cerebral and Cardiovascular Center Suita Japan., Motokawa T; Department of Cardiology Nagasaki University Hospital Nagasaki Japan., Miyamoto Y; Department of Medical and Health Information Management National Cerebral and Cardiovascular Center Suita Japan., Ohya Y; Department of Cardiology University of the Ryukyus Okinawa Japan., Miura SI; Department of Cardiology Fukuoka University School of Medicine Fukuoka Japan., Fukuma N; Department of Cardiovascular Medicine Nippon Medical School Bunkyo-ku Japan., Makita S; Department of Rehabilitation Kawaguchi Cupola Rehabilitation Hospital Kawaguchi Japan., Fukumoto Y; Division of Cardiovascular Medicine, Department of Medicine Kurume University School of Medicine Kurume Japan., Izawa H; Department of Cardiology Fujita Health University Toyoake Japan.
Πηγή: Journal of the American Heart Association [J Am Heart Assoc] 2026 Oct 06; Vol. 15 (19), pp. e051493. Date of Electronic Publication: 2026 Sep 24.
Τύπος έκδοσης: Journal Article
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Wiley-Blackwell Country of Publication: England NLM ID: 101580524 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2047-9980 (Electronic) Linking ISSN: 20479980 NLM ISO Abbreviation: J Am Heart Assoc Subsets: MEDLINE
Imprint Name(s): Original Publication: Oxford : Wiley-Blackwell
Ιατρικοί όροι (MeSH): Heart Failure*/rehabilitation , Heart Failure*/mortality , Heart Failure*/physiopathology , Heart Failure*/diagnosis , Cardiac Rehabilitation*/methods , Time-to-Treatment*, Japan/epidemiology ; Humans ; Female ; Registries ; Male ; Aged ; Hospital Mortality ; Time Factors ; Aged, 80 and over ; Acute Disease ; Treatment Outcome ; Hospitalization ; Middle Aged ; Risk Factors ; East Asian People
Περίληψη: Background: Cardiac rehabilitation (CR) improves outcomes in heart failure, but optimal initiation timing during acute hospitalization remains undefined. We characterized the dose-response association between door-to-cardiac rehabilitation time and in-hospital outcomes, describing how this pattern appeared to differ between death and functional measures.
Methods: Using the Japanese Registry of All Cardiac and Vascular Diseases-Diagnosis Procedure database, we identified 564 830 patients hospitalized for acute heart failure (2012-2023), categorized into non-CR (n=275 454) and CR groups by door-to-cardiac rehabilitation quartiles: quartile 1 (≤1 day), quartile 2 (2-3 days), quartile 3 (4-5 days), and quartile 4 (≥6 days). Generalized propensity score-based weighting adjusted for 32 confounders. Restricted cubic splines evaluated dose-response patterns among CR recipients. The primary outcome was in-hospital death; secondary outcomes were Barthel Index at discharge and Barthel Index improvement.
Results: All door-to-cardiac rehabilitation quartiles showed lower in-hospital death versus non-CR (adjusted odds ratios, 0.39-0.49; all P<0.001). Barthel Index at discharge was higher in quartile 1 to quartile 3 (mean difference, +3.2 to +3.8 points), with a smaller difference in quartile 4. Spline analysis revealed nonlinear associations: The mortality nadir was observed at 6.1 days, whereas functional measures showed the most favorable associations at 3.3 days. Sensitivity analyses addressing immortal time bias yielded consistent mortality results.
Conclusions: CR was associated with a lower in-hospital mortality rate across all timing quartiles. The association pattern appeared to differ by outcome domain: Functional measures showed more favorable associations with earlier initiation (within 2-3 days), whereas a lower mortality rate was observed across a broader window. These findings warrant prospective evaluation.
Contributed Indexing: Keywords: activities of daily living; cardiac rehabilitation; heart failure; hospital mortality; time‐to‐treatment
Entry Date(s): Date Created: 20260925 Date Completed: 20261008 Latest Revision: 20261009
Update Code: 20261010
DOI: 10.1161/JAHA.126.051493
PMID: 42786652
Βάση Δεδομένων: MEDLINE
FullText Text:
  Availability: 0
CustomLinks:
  – Url: https://resolver.ebsco.com/c/fiv2js/result?sid=EBSCO:cmedm&genre=article&issn=20479980&ISBN=&volume=15&issue=19&date=20261006&spage=e051493&pages=e051493&title=Journal of the American Heart Association&atitle=Door-to-Cardiac%20Rehabilitation%20Time%20and%20Clinical%20Outcomes%20in%20Patients%20Hospitalized%20for%20Acute%20Heart%20Failure%3A%20A%20Nationwide%20Japanese%20Registry.&aulast=Katano%20S&id=DOI:10.1161/JAHA.126.051493
    Name: Full Text Finder (for New FTF UI) (ns324271)
    Category: fullText
    Text: Full Text Finder
    MouseOverText: Full Text Finder
Header DbId: cmedm
DbLabel: MEDLINE
An: 42786652
AccessLevel: 3
PubType: Academic Journal
PubTypeId: academicJournal
PreciseRelevancyScore: 0
IllustrationInfo
Items – Name: Title
  Label: Title
  Group: Ti
  Data: Door-to-Cardiac Rehabilitation Time and Clinical Outcomes in Patients Hospitalized for Acute Heart Failure: A Nationwide Japanese Registry.
– Name: Author
  Label: Authors
  Group: Au
  Data: &lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Katano+S%22&quot;&gt;Katano S&lt;/searchLink&gt;; Division of Rehabilitation Sapporo Medical University Hospital Sapporo Japan.; Department of Rehabilitation Sapporo Medical University School of Medicine Sapporo Japan.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Yano+T%22&quot;&gt;Yano T&lt;/searchLink&gt;; Division of Cardiovascular-Kidney-Metabolic Medicine, Department of Internal Medicine Sapporo Medical University School of Medicine Sapporo Japan.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Kono+Y%22&quot;&gt;Kono Y&lt;/searchLink&gt;; Department of Rehabilitation Fujita Health University Hospital Toyoake Japan.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Sawamura+A%22&quot;&gt;Sawamura A&lt;/searchLink&gt;; Department of Cardiology Ichinomiya Municipal Hospital Ichinomiya Japan.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Kanaoka+K%22&quot;&gt;Kanaoka K&lt;/searchLink&gt;; Department of Medical and Health Information Management National Cerebral and Cardiovascular Center Suita Japan.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Motokawa+T%22&quot;&gt;Motokawa T&lt;/searchLink&gt;; Department of Cardiology Nagasaki University Hospital Nagasaki Japan.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Miyamoto+Y%22&quot;&gt;Miyamoto Y&lt;/searchLink&gt;; Department of Medical and Health Information Management National Cerebral and Cardiovascular Center Suita Japan.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Ohya+Y%22&quot;&gt;Ohya Y&lt;/searchLink&gt;; Department of Cardiology University of the Ryukyus Okinawa Japan.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Miura+SI%22&quot;&gt;Miura SI&lt;/searchLink&gt;; Department of Cardiology Fukuoka University School of Medicine Fukuoka Japan.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Fukuma+N%22&quot;&gt;Fukuma N&lt;/searchLink&gt;; Department of Cardiovascular Medicine Nippon Medical School Bunkyo-ku Japan.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Makita+S%22&quot;&gt;Makita S&lt;/searchLink&gt;; Department of Rehabilitation Kawaguchi Cupola Rehabilitation Hospital Kawaguchi Japan.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Fukumoto+Y%22&quot;&gt;Fukumoto Y&lt;/searchLink&gt;; Division of Cardiovascular Medicine, Department of Medicine Kurume University School of Medicine Kurume Japan.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Izawa+H%22&quot;&gt;Izawa H&lt;/searchLink&gt;; Department of Cardiology Fujita Health University Toyoake Japan.
– Name: TitleSource
  Label: Source
  Group: Src
  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22101580524%22&quot;&gt;Journal of the American Heart Association&lt;/searchLink&gt; [J Am Heart Assoc] 2026 Oct 06; Vol. 15 (19), pp. e051493. &lt;i&gt;Date of Electronic Publication: &lt;/i&gt;2026 Sep 24.
– Name: TypePub
  Label: Publication Type
  Group: TypPub
  Data: Journal Article
– Name: Language
  Label: Language
  Group: Lang
  Data: English
– Name: TitleSource
  Label: Journal Info
  Group: Src
  Data: &lt;i&gt;Publisher: &lt;/i&gt;&lt;searchLink fieldCode=&quot;PB&quot; term=&quot;%22Wiley-Blackwell%22&quot;&gt;Wiley-Blackwell &lt;/searchLink&gt;&lt;i&gt;Country of Publication: &lt;/i&gt;England &lt;i&gt;NLM ID: &lt;/i&gt;101580524 &lt;i&gt;Publication Model: &lt;/i&gt;Print-Electronic &lt;i&gt;Cited Medium: &lt;/i&gt;Internet &lt;i&gt;ISSN: &lt;/i&gt;2047-9980 (Electronic) &lt;i&gt;Linking ISSN: &lt;/i&gt;&lt;searchLink fieldCode=&quot;IS&quot; term=&quot;%2220479980%22&quot;&gt;20479980 &lt;/searchLink&gt;&lt;i&gt;NLM ISO Abbreviation: &lt;/i&gt;J Am Heart Assoc &lt;i&gt;Subsets: &lt;/i&gt;MEDLINE
– Name: PublisherInfo
  Label: Imprint Name(s)
  Group: PubInfo
  Data: &lt;i&gt;Original Publication&lt;/i&gt;: Oxford : Wiley-Blackwell
– Name: SubjectMESH
  Label: MeSH Terms
  Group: Su
  Data: &lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Heart+Failure%22&quot;&gt;Heart Failure*&lt;/searchLink&gt;/&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Heart+Failure+rehabilitation%22&quot;&gt;rehabilitation&lt;/searchLink&gt; &lt;br /&gt;&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Heart+Failure%22&quot;&gt;Heart Failure*&lt;/searchLink&gt;/&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Heart+Failure+mortality%22&quot;&gt;mortality&lt;/searchLink&gt; &lt;br /&gt;&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Heart+Failure%22&quot;&gt;Heart Failure*&lt;/searchLink&gt;/&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Heart+Failure+physiopathology%22&quot;&gt;physiopathology&lt;/searchLink&gt; &lt;br /&gt;&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Heart+Failure%22&quot;&gt;Heart Failure*&lt;/searchLink&gt;/&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Heart+Failure+diagnosis%22&quot;&gt;diagnosis&lt;/searchLink&gt; &lt;br /&gt;&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Cardiac+Rehabilitation%22&quot;&gt;Cardiac Rehabilitation*&lt;/searchLink&gt;/&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Cardiac+Rehabilitation+methods%22&quot;&gt;methods&lt;/searchLink&gt; &lt;br /&gt;&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Time-to-Treatment%22&quot;&gt;Time-to-Treatment*&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Japan%22&quot;&gt;Japan&lt;/searchLink&gt;/&lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Japan+epidemiology%22&quot;&gt;epidemiology&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Humans%22&quot;&gt;Humans&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Female%22&quot;&gt;Female&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Registries%22&quot;&gt;Registries&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Male%22&quot;&gt;Male&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Aged%22&quot;&gt;Aged&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Hospital+Mortality%22&quot;&gt;Hospital Mortality&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Time+Factors%22&quot;&gt;Time Factors&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Aged%2C+80+and+over%22&quot;&gt;Aged, 80 and over&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Acute+Disease%22&quot;&gt;Acute Disease&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Treatment+Outcome%22&quot;&gt;Treatment Outcome&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Hospitalization%22&quot;&gt;Hospitalization&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Middle+Aged%22&quot;&gt;Middle Aged&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Risk+Factors%22&quot;&gt;Risk Factors&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22East+Asian+People%22&quot;&gt;East Asian People&lt;/searchLink&gt;
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background: Cardiac rehabilitation (CR) improves outcomes in heart failure, but optimal initiation timing during acute hospitalization remains undefined. We characterized the dose-response association between door-to-cardiac rehabilitation time and in-hospital outcomes, describing how this pattern appeared to differ between death and functional measures.&lt;br /&gt;Methods: Using the Japanese Registry of All Cardiac and Vascular Diseases-Diagnosis Procedure database, we identified 564 830 patients hospitalized for acute heart failure (2012-2023), categorized into non-CR (n=275 454) and CR groups by door-to-cardiac rehabilitation quartiles: quartile 1 (≤1 day), quartile 2 (2-3 days), quartile 3 (4-5 days), and quartile 4 (≥6 days). Generalized propensity score-based weighting adjusted for 32 confounders. Restricted cubic splines evaluated dose-response patterns among CR recipients. The primary outcome was in-hospital death; secondary outcomes were Barthel Index at discharge and Barthel Index improvement.&lt;br /&gt;Results: All door-to-cardiac rehabilitation quartiles showed lower in-hospital death versus non-CR (adjusted odds ratios, 0.39-0.49; all P&amp;lt;0.001). Barthel Index at discharge was higher in quartile 1 to quartile 3 (mean difference, +3.2 to +3.8 points), with a smaller difference in quartile 4. Spline analysis revealed nonlinear associations: The mortality nadir was observed at 6.1 days, whereas functional measures showed the most favorable associations at 3.3 days. Sensitivity analyses addressing immortal time bias yielded consistent mortality results.&lt;br /&gt;Conclusions: CR was associated with a lower in-hospital mortality rate across all timing quartiles. The association pattern appeared to differ by outcome domain: Functional measures showed more favorable associations with earlier initiation (within 2-3 days), whereas a lower mortality rate was observed across a broader window. These findings warrant prospective evaluation.
– Name: SubjectMinor
  Label: Contributed Indexing
  Group:
  Data: &lt;i&gt;Keywords: &lt;/i&gt;activities of daily living; cardiac rehabilitation; heart failure; hospital mortality; time‐to‐treatment
– Name: DateEntry
  Label: Entry Date(s)
  Group: Date
  Data: &lt;i&gt;Date Created: &lt;/i&gt;20260925 &lt;i&gt;Date Completed: &lt;/i&gt;20261008 &lt;i&gt;Latest Revision: &lt;/i&gt;20261009
– Name: DateUpdate
  Label: Update Code
  Group: Date
  Data: 20261010
– Name: DOI
  Label: DOI
  Group: ID
  Data: 10.1161/JAHA.126.051493
– Name: AN
  Label: PMID
  Group: ID
  Data: 42786652
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=cmedm&AN=42786652
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1161/JAHA.126.051493
    Languages:
      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        StartPage: e051493
    Subjects:
      – SubjectFull: Japan epidemiology
        Type: general
      – SubjectFull: Humans
        Type: general
      – SubjectFull: Female
        Type: general
      – SubjectFull: Registries
        Type: general
      – SubjectFull: Male
        Type: general
      – SubjectFull: Aged
        Type: general
      – SubjectFull: Hospital Mortality
        Type: general
      – SubjectFull: Time Factors
        Type: general
      – SubjectFull: Aged, 80 and over
        Type: general
      – SubjectFull: Acute Disease
        Type: general
      – SubjectFull: Treatment Outcome
        Type: general
      – SubjectFull: Hospitalization
        Type: general
      – SubjectFull: Middle Aged
        Type: general
      – SubjectFull: Risk Factors
        Type: general
      – SubjectFull: East Asian People
        Type: general
      – SubjectFull: Heart Failure rehabilitation
        Type: general
      – SubjectFull: Heart Failure mortality
        Type: general
      – SubjectFull: Heart Failure physiopathology
        Type: general
      – SubjectFull: Heart Failure diagnosis
        Type: general
      – SubjectFull: Cardiac Rehabilitation methods
        Type: general
      – SubjectFull: Time-to-Treatment
        Type: general
    Titles:
      – TitleFull: Door-to-Cardiac Rehabilitation Time and Clinical Outcomes in Patients Hospitalized for Acute Heart Failure: A Nationwide Japanese Registry.
        Type: main
  BibRelationships:
    HasContributorRelationships:
      – PersonEntity:
          Name:
            NameFull: Katano S
      – PersonEntity:
          Name:
            NameFull: Yano T
      – PersonEntity:
          Name:
            NameFull: Kono Y
      – PersonEntity:
          Name:
            NameFull: Sawamura A
      – PersonEntity:
          Name:
            NameFull: Kanaoka K
      – PersonEntity:
          Name:
            NameFull: Motokawa T
      – PersonEntity:
          Name:
            NameFull: Miyamoto Y
      – PersonEntity:
          Name:
            NameFull: Ohya Y
      – PersonEntity:
          Name:
            NameFull: Miura SI
      – PersonEntity:
          Name:
            NameFull: Fukuma N
      – PersonEntity:
          Name:
            NameFull: Makita S
      – PersonEntity:
          Name:
            NameFull: Fukumoto Y
      – PersonEntity:
          Name:
            NameFull: Izawa H
    IsPartOfRelationships:
      – BibEntity:
          Dates:
            – D: 06
              M: 10
              Text: 2026 Oct 06
              Type: published
              Y: 2026
          Identifiers:
            – Type: issn-electronic
              Value: 2047-9980
          Numbering:
            – Type: volume
              Value: 15
            – Type: issue
              Value: 19
          Titles:
            – TitleFull: Journal of the American Heart Association
              Type: main
ResultId 1